Dental Board of California
Licensing details for: 19190
Name: FOLSOM HILLS DENTISTRY DENTAL GROUP, O'DONNELL DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
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: MOKBIL, AHMAD
License/Registration Type: Dentist License
License Number: 101058 Primary Status: Current - Active
Address :
1016 Riley St
1
1016 Riley St
FOLSOM CA 95630-3265
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: VICUNA, SERGIO
License/Registration Type: Dentist License
License Number: 53129 Primary Status: Current - Active
Address :
5004 S Land Park Dr
SACRAMENTO CA 95822-2504
SACRAMENTO 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: O'Donnell, Ryan
License/Registration Type: Dentist License
License Number: 100369 Primary Status: Current - Active
Address :
2465 Iron Point Rd
Suite 120
FOLSOM CA 95630-8754
SACRAMENTO 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: GILL, AMARDEEP KAUR
License/Registration Type: Dentist License
License Number: 50464 Primary Status: Current - Active
Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO 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: MASBRATA, ABIGAIL THERESA
License/Registration Type: Dentist License
License Number: 107830 Primary Status: Current - Active
Address :
2465 Iron Point Rd
Ste #120
FOLSOM CA 95630
SACRAMENTO COUNTY
