Dental Board of California
Licensing details for: 18726
Name: BLOSSOM HILL DENTAL CENTER DENTAL OFFICE OF DR. AGRAWAL
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: JAIN, DEEPIKA
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: AGRAWAL, PRATIKSHA
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: AGRAWAL, PRATIKSHA
License/Registration Type: Dentist License
License Number: 105767 Primary Status: Current - Active
Address :
933 Planetree Pl
SUNNYVALE CA 94086-8650
SANTA CLARA COUNTY
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: JAIN, DEEPIKA
License/Registration Type: Dentist License
License Number: 44705 Primary Status: Current - Active
Address :
2454 STORY RD
SAN JOSE CA 95122
SANTA CLARA COUNTY
