Dental Board of California
Licensing details for: 11708
Name: VILLA LA JOLLA DENTAL, OFFICE OF RICHARD C. EVANGELISTA, D.D.S.,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: VILLA LA JOLLA DENTAL
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: EVANGELISTA, RICHARD CARLOS
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: EVANGELISTA, RICHARD CARLOS
License/Registration Type: Dentist License
License Number: 47258 Primary Status: Current - Active
Address :
450 Sutter St
#2633
SAN FRANCISCO CA 94108-4206
SAN FRANCISCO COUNTY
