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Licensing details for: 13241

Name: GREEN VALLEY DENTAL GROUP KNIGHT DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2205 FRANCISCO DRIVE, SUITE 150
EL DORADO HILLS CA 95762
EL DORADO county
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Practice Location

2205 FRANCISCO DRIVE, SUITE 150
EL DORADO HILLS CA 95762
EL DORADO county
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Issuance Date

December 20, 2016

Expiration Date

January 31, 2027

Current Date / Time

June 6, 2025
1:31:59 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KNIGHT, VICENTE PAUL

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GILL, AMARDEEP KAUR

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHAZAL, CAROLYN G

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LAMBRIDIS, DEAN

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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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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: KNIGHT, VICENTE PAUL

License/Registration Type: Dentist License

License Number: 62280 Primary Status: Current - Active

Address :
2205 FRANCISCO DR. SUITE 150
EL DORADO HILLS CA 95762
EL DORADO COUNTY

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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: LAMBRIDIS, DEAN

License/Registration Type: Dentist License

License Number: 51199 Primary Status: Current - Active

Address :
30831 MARSEILLE WAY
WESTLAKE VILLAGE CA 91362
VENTURA COUNTY

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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: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY

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