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Licensing details for: 16288

Name: SPARKLE KIDS DENTAL CARE, DENTAL OFFICE OF KAUR & BORRERO DDS DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1801 TULLY RD., STE A.1
MODESTO CA 95350
STANISLAUS county
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Practice Location

1801 TULLY RD., STE A.1
MODESTO CA 95350
STANISLAUS county
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Issuance Date

February 9, 2021

Expiration Date

November 30, 2025

Current Date / Time

June 6, 2025
10:8:45 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KAUR, KARMJIT

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BORRERO FONSECA, MARIA CAMILA

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: Borrero Fonseca, Maria Camila

License/Registration Type: Dentist License

License Number: 51046 Primary Status: Current - Active

Address :
569 W LOWELL AVE
STE 200
TRACY CA 95376
SAN JOAQUIN COUNTY

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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: KAUR, KARMJIT

License/Registration Type: Dentist License

License Number: 59660 Primary Status: Current - Active

Address :
1726 TINNIN ROAD
MANTECA CA 95337
SAN JOAQUIN COUNTY

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