Dental Board of California
Licensing details for: 3252
Name: BLUE RIVER FAMILY DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
730 SUNRISE AVENUE #120
ROSEVILLE CA 95661
PLACER county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FONDREN, SINDY NGUYEN
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: FONDREN, SINDY NGUYEN
License/Registration Type: Dentist License
License Number: 43825 Primary Status: Current - Active
Address :
576 North Sunrise Avenue
140
ROSEVILLE CA 95661
PLACER COUNTY
