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Licensing details for: 16479

Name: ALAMEDA LANDING DENTISTRY DENTAL GROUP, GRACE MIN DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2660 5TH ST, STE C
ALAMEDA CA 94501
ALAMEDA county
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Practice Location

2660 5TH ST, STE C
ALAMEDA CA 94501
ALAMEDA county
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Issuance Date

April 22, 2021

Expiration Date

September 30, 2025

Current Date / Time

June 7, 2025
4:27:44 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GILL, AMARDEEP KAUR

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAUTISTA, REYMOND CARBONELL

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PATEL, DHAVAL RAMAN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MIN, GRACE HYUNSUNG

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: MIN, GRACE HYUNSUNG

License/Registration Type: Dentist License

License Number: 56845 Primary Status: Current - Active

Address :
8211 Bruceville Rd
Ste 155
SACRAMENTO CA 95823-2357
SACRAMENTO 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: GILL, AMARDEEP KAUR

License/Registration Type: Dentist License

License Number: 50464 Primary Status: Current - Active

Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO 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: BAUTISTA, REYMOND CARBONELL

License/Registration Type: Dentist License

License Number: 56217 Primary Status: Current - Active

Address :
1221 Albright Walk
SACRAMENTO CA 95818-1682
SACRAMENTO 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: PATEL, DHAVAL RAMAN

License/Registration Type: Dentist License

License Number: 54297 Primary Status: Current - Active

Address :
10357 Fairway Dr
Ste 100
ROSEVILLE CA 95678-3544
PLACER COUNTY

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