Dental Board of California
Licensing details for: 12416
Name: TERRA VISTA DENTAL CARE DENTAL OFFICE OF DR. KEYURKUMAR PATEL
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
7211 HAVEN AVENUE, #D
RANCHO CUCAMONGA CA 91701
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PATEL, KEYURKUMAR RATILAL
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: PATEL, KEYURKUMAR RATILAL
License/Registration Type: Dentist License
License Number: 54570 Primary Status: Deceased
Address :
7211 Haven Ave
suite D
RANCHO CUCAMONGA CA 91701-6064
SAN BERNARDINO COUNTY
