Dental Board of California
Licensing details for: 12697
Name: ELK GROVE KIDS DENTIST AND ORTHODONTICS, DENTAL PRACTICE OF ELSEMARY & SALEM DENTAL CORP
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
9045 BRUCEVILLE ROAD, SUITE 110
ELK GROVE CA 95758
SACRAMENTO county
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License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SALEM, AHMED
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ELSEMARY, NAGY RAMADAN A
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: SALEM, AHMED
License/Registration Type: Dentist License
License Number: 50364 Primary Status: Current - Active
Address :
9707 Blansfield Way
ELK GROVE CA 95757-4021
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: ELSEMARY, NAGY RAMADAN A
License/Registration Type: Dentist License
License Number: 47882 Primary Status: Expired
Address :
7310 Cordially Way
ELK GROVE CA 95757-6219
SACRAMENTO COUNTY
