Dental Board of California
Licensing details for: 18150
Name: PLACER SMILES PEDIATRIC DENTISTRY DENTAL PRACTICE OF CA GONZALEZ 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: GONZALEZ, CUAUHTEMOC AZTLAN
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: GONZALEZ, CUAUHTEMOC AZTLAN
License/Registration Type: Dentist License
License Number: 101166 Primary Status: Current - Active
Address :
11230 Gold Express Dr
Suite 302
GOLD RIVER CA 95670-4484
SACRAMENTO COUNTY
