Dental Board of California
Licensing details for: 10150
Name: SHADELANDS ENDODONTICS AND MICROSURGERY, DENTAL GROUP OF CHINTA D
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: SHADELANDS ENDODONTICS AND MICROSURGERY CHINTA DENTAL CORPORATION
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CHINTA, SUDHA SESHA
Address Not Disclosed
FNP to DDS or OMS
License/Registration Role: Fictitious Name Permit
Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Name: CHINTA, SUDHA SESHA
License/Registration Type: Dentist License
License Number: 43769 Primary Status: Current - Active
Address :
103 SYCAMORE VALLEY ROAD WEST
DANVILLE CA 94526
CONTRA COSTA COUNTY
