Dental Board of California
Licensing details for: 5111
Name: SIGNATURE DENTAL PRACTICE, PETER A MOOSMAN, DDS,
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Address of Record
2505 S BASCOM AVE
CAMPBELL CA 95008
SANTA CLARA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MOOSMAN, PETER ALLAN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MOOSMAN, PETER
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: MOOSMAN, PETER ALLAN
License/Registration Type: Dentist License
License Number: 42187 Primary Status: Current - Active
Address :
13575 Foothill Ave
SAN MARTIN CA 95046-9608
SANTA CLARA COUNTY
