Dental Board of California
Licensing details for: 14030
Name: PLACERVILLE DENTAL CARE, PRACTICE OF GUGALE & AZOUZ DENTAL GROUP OF PLACERVILLE, INC.
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: AZOUZ, DARRYL TODD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GUGALE, MONIKA SACHIN
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: GUGALE, MONIKA SACHIN
License/Registration Type: Dentist License
License Number: 49104 Primary Status: Current - Active
Address :
941 Spring St
Suite 6
PLACERVILLE CA 95667-4546
EL DORADO 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: AZOUZ, DARRYL TODD
License/Registration Type: Dentist License
License Number: 47447 Primary Status: Current - Active
Address :
5414 Sunrise Blvd Ste F
CITRUS HEIGHTS CA 95610-7803
SACRAMENTO COUNTY
