Dental Board of California
Licensing details for: 3372
Name: ELK GROVE DENTAL CARE DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Address of Record
9105 BRUCEVILLE ROAD, SUITE 8-A
ELK GROVE CA 95758
SACRAMENTO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHANKAR, VISHNU
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: SHANKAR, VISHNU
License/Registration Type: Dentist License
License Number: 39707 Primary Status: Current - Active
Address :
504 Linden Ave
SAN BRUNO CA 94066
SAN MATEO COUNTY
