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Licensing details for: 16307

Name: BRENTWOOD CHILDREN DENTISTRY- DENTAL PRACTICE OF REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: BRENTWOOD CHILDREN DENTISTRY - DENTAL PRACTICE OF REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION REEVES, D.D.S., AND LAVALLEY, D.D.S., A DENTAL CORPORATION

Address of Record

2221 BALFOUR RD. STE D
BRENTWOOD CA 94513
CONTRA COSTA county
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Practice Location

2221 BALFOUR RD., STE D
BRENTWOOD CA 94513
CONTRA COSTA county
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Issuance Date

February 16, 2021

Expiration Date

July 31, 2024

Current Date / Time

June 6, 2025
2:12:58 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REEVES, AARON PAUL

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: REEVES, AARON PAUL

License/Registration Type: Dentist License

License Number: 47785 Primary Status: Current - Active

Address :
2277 Fair Oaks Blvd
Ste 330
SACRAMENTO CA 95825
SACRAMENTO COUNTY

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