Dental Board of California
Licensing details for: 14934
Name: CHARMING SMILES OF LA QUINTA DENTAL PRACTICE OF NIETO DENTAL CORP
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: NIETO, ANGELICA MARIA
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: NIETO, ANGELICA MARIA
License/Registration Type: Dentist License
License Number: 60200 Primary Status: Current - Active
Address :
78995 Highway 111 Ste 3
LA QUINTA CA 92253-2397
RIVERSIDE COUNTY
