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Licensing details for: 11513

Name: KIDS CARE DENTAL - NATOMAS, DENTAL PRACTICE OF REEVES, D.D.S. AND

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: KIDS CARE DENTAL - NATOMAS DENTAL PRACTICE OF REEVES, DDS AND LAVALLEY, DDS A DENTAL CORPORATION

Address of Record

4670 NATOMAS BLVD STE 100
SACRAMENTO CA 95835-1217
SACRAMENTO county
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Practice Location

4670 NATOMAS BLVD STE 100
SACRAMENTO CA 95835
SACRAMENTO county
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Issuance Date

September 9, 2014

Expiration Date

July 31, 2020

Current Date / Time

June 6, 2025
1:40:9 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REEVES, AARON PAUL

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LAVALLEY, SAMUEL JOSEPH JR

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: REEVES, AARON PAUL

License/Registration Type: Dentist License

License Number: 47785 Primary Status: Current - Active

Address :
2277 Fair Oaks Blvd
Ste 330
SACRAMENTO CA 95825
SACRAMENTO 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: LAVALLEY, SAMUEL JOSEPH JR

License/Registration Type: Dentist License

License Number: 62274 Primary Status: Cancelled

Address :
3211 14TH AVENUE
MENOMINEE MI 49858
MENOMINEE COUNTY

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