Dental Board of California
Licensing details for: 20496
Name: Dentists of El Dorado Hills, Dental Group of Dentists of El Dorado Hills, Inc.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
3381 Bass Lake Rd, Ste 140
EL DORADO HILLS CA 95762
Map
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: KIM, MELANIE MIDORI
License/Registration Type: Dentist License
License Number: 103560 Primary Status: Current - Active
Address :
3381 Bass Lake Rd
Ste 140
EL DORADO HILLS CA 95762-6633
EL DORADO 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: PETERSEN, MELISSA
License/Registration Type: Dentist License
License Number: 58013 Primary Status: Current - Active
Address :
3381 Bass Lake Rd
Unit 140
EL DORADO HILLS CA 95762-6633
EL DORADO 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: 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: JEONG, DONG JUN
License/Registration Type: Dentist License
License Number: 61931 Primary Status: Current - Active
Address :
10910 OLSEN DR. SUITE 100
RANCHO CORDOVA CA 95670
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: 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
