Dental Board of California
Licensing details for: 13672
Name: BERRYESSA DENTAL SPA, DENTAL OFFICE OF ASHMITA SHETTY, DDS. A PROFESSIONAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHETTY, ASHMITA
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: SHETTY, ASHMITA
License/Registration Type: Dentist License
License Number: 46683 Primary Status: Current - Active
Address :
2664 BERRYESSA RD. SUITE 104
SAN JOSE CA 95132
SANTA CLARA COUNTY
