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Licensing details for: 16016

Name: CHILDREN'S CHOICE DENTAL CARE DENTAL PRACTICE OF DR. JEFFREY A SALADIN, DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2057 TULLY RD., SUITE A
MODESTO CA 95350
STANISLAUS county
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Practice Location

2057 TULLY RD., SUITE A
MODESTO CA 95350
STANISLAUS county
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Issuance Date

September 21, 2020

Expiration Date

September 30, 2024

Current Date / Time

June 7, 2025
9:51:8 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: HUDSON, PAGE ALLEN

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: HUDSON, PAGE ALLEN

License/Registration Type: Dentist License

License Number: 36249 Primary Status: Current - Active

Address :
5150 5th St
RAPID CITY SD 57701-6023
PENNINGTON COUNTY

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