Dental Board of California
Licensing details for: 4567
Name: THE DENTAL SPA AT MISSION HILLS, DENTAL PRACTICE,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Address of Record
194 FRANCISCO LN, STE 112
FREMONT CA 94539
ALAMEDA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: EVANGELISTA, RICHARD CARLOS
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: EVANGELISTA, RICHARD CARLOS
License/Registration Type: Dentist License
License Number: 47258 Primary Status: Current - Active
Address :
450 Sutter St
#2633
SAN FRANCISCO CA 94108-4206
SAN FRANCISCO COUNTY
