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Licensing details for: 16308

Name: KIDS CARE DENTAL MANTECA - 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: KIDS CARE DENTAL & ORTHODONTICS - STONECREEK DENTAL OFFICE OF REEVES, D.D.S., AND LAVALLEY, D.D.S., A DENTAL CORPORATION KIDS CARE DENTAL STONECREEK - DENTAL PRACTICE OF REEVES, D.D.S., AND LAVALLEY, D.D.S., A DENTAL CORPORATION

Address of Record

115 SPRECKLES AVE
MANTECA CA 95336
SAN JOAQUIN county
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Practice Location

115 SPRECKLES AVE
MANTECA CA 95336
SAN JOAQUIN county
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Issuance Date

February 16, 2021

Expiration Date

July 31, 2022

Current Date / Time

October 30, 2025
9:55:52 PM

License Relationships

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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