Dental Board of California
Licensing details for: 17315
Name: SPARK FAMILY DENTAL, DENTAL GROUP OF MADHAVI SURESH SERI DDS INC
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: SERI, MADHAVI SURESH
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: SERI, MADHAVI SURESH
License/Registration Type: Dentist License
License Number: 102211 Primary Status: Current - Active
Address :
1940 N Tracy Blvd
TRACY CA 95376-2423
SAN JOAQUIN COUNTY
