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Licensing details for: 4890

Name: GENTLE DENTAL STOCKTON, A DENTAL OFFICE OF

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

555 W BENJAMIN HOLT DR
STE 100
STOCKTON CA 95207
SAN JOAQUIN county
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Issuance Date

April 19, 2004

Expiration Date

May 31, 2011

Current Date / Time

June 6, 2025
1:54:16 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NAKAKI, ROBERT PAUL

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: NAKAKI, ROBERT PAUL

License/Registration Type: Dentist License

License Number: 28963 Primary Status: Current - Active

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

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