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Licensing details for: 81566

Name: CASTILLO DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

10842 BEAR HOLLOW DRIVE SUITE 101
RANCHO CORDOVA CA 95670
SACRAMENTO county
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Practice Location

10842 BEAR HOLLOW DRIVE SUITE 101
RANCHO CORDOVA CA 95670
SACRAMENTO county
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Issuance Date

August 1, 2023

Expiration Date

January 31, 2026

Current Date / Time

June 6, 2025
7:43:13 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: CASTILLO, MICHAEL FRANCIS

License/Registration Type: Dentist License

License Number: 108201 Primary Status: Current - Active

Address :
10842 Bear Hollow Drive
Suite 101
RANCHO CORDOVA CA 95670
SACRAMENTO COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: BAUTISTA, REYMOND CARBONELL

License/Registration Type: Dentist License

License Number: 56217 Primary Status: Current - Active

Address :
1221 Albright Walk
SACRAMENTO CA 95818-1682
SACRAMENTO COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: MOKBIL, AHMAD

License/Registration Type: Dentist License

License Number: 101058 Primary Status: Current - Active

Address :
1016 Riley St
1
1016 Riley St
FOLSOM CA 95630-3265

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY

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AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: JEONG, DONG JUN

License/Registration Type: Dentist License

License Number: 61931 Primary Status: Current - Active

Address :
10910 OLSEN DR. SUITE 100
RANCHO CORDOVA CA 95670
SACRAMENTO COUNTY

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