Dental Board of California
Licensing details for: 3276
Name: CUPERTINO ENDODONTIC DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
10363 TORRE AVE STE E
CUPERTINO CA 95014
SANTA CLARA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HAYMORE, BRIAN DANIEL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PUCCINELLI, LAWRENCE ANDREW JR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PUCCINELLI, LAWRENCE A
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HAYMORE, BRIAN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PUCCINELLI, LAWRENCE A SR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PUCCINELLI, LAWRENCE A JR
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: HAYMORE, BRIAN DANIEL
License/Registration Type: Dentist License
License Number: 42829 Primary Status: Current - Active
Address :
321 A St
ENCINITAS CA 92024-3221
SAN DIEGO 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: PUCCINELLI, LAWRENCE A
License/Registration Type: Dentist License
License Number: 20253 Primary Status: Cancelled
Address :
261 VALLEJO CT
MILLBRAE CA 94030
SAN MATEO 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: PUCCINELLI, LAWRENCE ANDREW JR
License/Registration Type: Dentist License
License Number: 42214 Primary Status: Current - Active
Address :
15075 Los Gatos Blvd Ste 120
LOS GATOS CA 95032-2049
SANTA CLARA COUNTY
