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Licensing details for: 10816

Name: UDC DENTAL GROUP, PRACTICE OF ULLOA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: UDC DENTAL GROUP PRACTICE OF ULLOA DENTAL CORPORATION

Address of Record

2480 MISSION STREET SUITE 105
SAN FRANCISCO CA 94110
SAN FRANCISCO county
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Practice Location

2480 MISSION STREET SUITE 105
SAN FRANCISCO CA 94110
SAN FRANCISCO county
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Issuance Date

October 9, 2013

Expiration Date

November 30, 2017

Current Date / Time

June 7, 2025
3:7:3 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ULLOA, BRAULIO YEZID

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ULLOA, OMAR DANIEL

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: ULLOA, OMAR DANIEL

License/Registration Type: Dentist License

License Number: 45209 Primary Status: Current - Active

Address :
3448 MISSION ST.
SAN FRANCISCO CA 94110
SAN FRANCISCO COUNTY

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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: ULLOA, BRAULIO YEZID

License/Registration Type: Dentist License

License Number: 47673 Primary Status: Current - Active

Address :
3448 Mission St
SAN FRANCISCO CA 94110-5437
SAN FRANCISCO COUNTY

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