Dental Board of California
Licensing details for: 3433
Name: COURT STREET FAMILY DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: COURT STREET FAMILY DENTISTRY
Address of Record
518 NORTH COURT, STE C
VISALIA CA 93618
TULARE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MEDINA-RANGEL, DIANA M
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MEDINA-RANGEL, DIANA MARCELA
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: MEDINA-RANGEL, DIANA MARCELA
License/Registration Type: Dentist License
License Number: 46296 Primary Status: Current - Active
Address :
ADVENTIST HEALTH DENTAL
1025 N DOUTY ST
HANFORD CA 93230
KINGS COUNTY
