Dental Board of California
Licensing details for: 12294
Name: KIDS CARE DENTAL - LODI DENTAL PRACTICE OF REEVES, DDS AND LAVALL
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
1361 SOUTH LOWER SACRAMENTO ROAD
#601
LODI CA 95242-9296
SAN JOAQUIN 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: 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
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
