Dental Board of California
Licensing details for: 18206
Name: PARK PLACE DENTAL SAN MATEO DENTAL GROUP OF RICHARD C. EVANGELISTA, DDS
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
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: EVANGELISTA, RICHARD CARLOS
License/Registration Type: Dentist License
License Number: 47258 Primary Status: Current - Active
Address :
450 Sutter St
#2633
SAN FRANCISCO CA 94108-4206
SAN FRANCISCO COUNTY
