Dental Board of California
Licensing details for: 15826
Name: MODERN DENTAL AND IMPLANTS, DENTAL OFFICE OF GILL DALLA DENTAL INC.
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: 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
