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Licensing details for: 20489

Name: Crocker Ranch Dentistry, Dental Group of Crocker Ranch Dentistry, Prof. Corp.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

9055 Woodcreek Oaks Blvd. Suite 150
ROSEVILLE CA 95747
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Issuance Date

March 25, 2026

Expiration Date

March 31, 2028

Current Date / Time

April 3, 2026
3:18:51 AM

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: CHO, TAEWON TAD

License/Registration Type: Dentist License

License Number: 110270 Primary Status: Current - Active

Address :
2465 Iron Point Rd
#120
FOLSOM CA 95630-8754
SACRAMENTO COUNTY

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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

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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

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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: PATEL, DHAVAL RAMAN

License/Registration Type: Dentist License

License Number: 54297 Primary Status: Current - Active

Address :
10357 Fairway Dr
Ste 100
ROSEVILLE CA 95678-3544
PLACER COUNTY

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