Dental Board of California
Licensing details for: 14083
Name: GREAT SMILES DENTAL, PRACTICE OF DRS. PANNU AND HENNE-BHULLAR
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HENNE-BHULLAR, MISTY AUTUMN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PANNU, DALVIR SINGH
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: HENNE-BHULLAR, MISTY AUTUMN
License/Registration Type: Dentist License
License Number: 101918 Primary Status: Current - Active
Address :
1660 Willow St
Suite 7
SAN JOSE CA 95125-5101
SANTA CLARA 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: PANNU, DALVIR SINGH
License/Registration Type: Dentist License
License Number: 47148 Primary Status: Current - Active
Address :
2195 Silver View Ct
SAN JOSE CA 95138-2447
SANTA CLARA COUNTY
