Dental Board of California
Licensing details for: 3188
Name: CIVIC DENTAL ASSOCIATES
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
1212 12TH STREET
MODESTO CA 95354
STANISLAUS county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RICE, JEFFREY SCOTT
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: RICE, JEFFREY SCOTT
License/Registration Type: Dentist License
License Number: 41529 Primary Status: Current - Active
Address :
3950 Geer Rd
TURLOCK CA 95382-1147
STANISLAUS COUNTY
