Dental Board of California
Licensing details for: 18657
Name: PENINSULA ORAL SURGERY SAN JOSE, DENTAL GROUP OF M. ELDER, D.D.S., A PROFESSIONAL CORPORATION
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: ELDER, MAHR F
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: ELDER, MAHR F
License/Registration Type: Dentist License
License Number: 46586 Primary Status: Current - Active
Address :
1805 Novato Blvd
Suite 1
NOVATO CA 94947-2934
MARIN COUNTY
