Dental Board of California
Licensing details for: 1072
Name: TOWNGATE FAMILY DENTAL OFFICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: TOWNGATE FAMILY DENTAL OFFICE, DR. UDAYN SHAH
Address of Record
DR UDAYN SHAH
12625 FREDERICK STREET STE F12
MORENO VALLEY CA 92553
RIVERSIDE county
Map
License Relationships
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: SHAH, UDAY N
License/Registration Type: Dentist License
License Number: 36426 Primary Status: Current - Active
Address :
14708 Pipeline Ave
Ste # A
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
