Dental Board of California
Licensing details for: 11920
Name: VALLEY CHILDREN'S DENTISTRY AND ORTHODONTICS, DENTAL OFFICE OF DR
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PRIETO, JORDAN DAVID
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: PRIETO, JORDAN DAVID
License/Registration Type: Dentist License
License Number: 61309 Primary Status: Current - Active
Address :
1900 Shaw Ave
101
CLOVIS CA 93611-4208
FRESNO COUNTY
