Dental Board of California
Licensing details for: 4744
Name: FULFORD ORTHODONTICS DENTAL PRACTICE, REGINALD L FULFORD,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
511 EL CERRITO PLAZA
EL CERRITO CA 94530
CONTRA COSTA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FULFORD, REGINALD LAMAR
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: FULFORD, REGINALD LAMAR
License/Registration Type: Dentist License
License Number: 49520 Primary Status: Current - Active
Address :
208 Classic Ct
WEST SACRAMENTO CA 95605-2567
SACRAMENTO COUNTY
