Dental Board of California
Licensing details for: 17294
Name: KIDS HOPE DENTAL PRACTICE OF BORRERO DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BORRERO FONSECCA, MARIA
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
