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Licensing details for: 14715

Name: WOODLAND FAMILY DENTAL GROUP DALLA

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

58 W COURT ST
WOODLAND CA 95695
YOLO county
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Practice Location

58 W COURT ST
WOODLAND CA 95695
YOLO county
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Issuance Date

December 26, 2018

Expiration Date

November 30, 2021

Current Date / Time

June 7, 2025
3:1:54 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GILL, AMANDEEP 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: GILL, AMANDEEP SINGH

License/Registration Type: Dentist License

License Number: 61025 Primary Status: Current - Active

Address :
1548 MAEHL DR
MANTECA CA 95337
SAN JOAQUIN COUNTY

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