Dental Board of California
Licensing details for: 14370
Name: SEASIDE PERIO CENTRE DR. L SWAYAMPRAKASAM DENTAL GROUP
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: SWAYAMPRAKASAM, LOGESH
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: SWAYAMPRAKASAM, LOGESH
License/Registration Type: Dentist License
License Number: 100140 Primary Status: Current - Active
Address :
3200 Mowry avenue
Suite 102
FREMONT CA 94538
