Dental Board of California
Licensing details for: 5819
Name: BRENTWOOD DENTAL CENTER, DENTAL PRACTICE OF
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Partnership
Address of Record
5611 Lone Tree Way Ste 140
BRENTWOOD CA 94513-5315
CONTRA COSTA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: EVANGELISTA, RICHARD CARLOS
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: EVANGELISTA, RICHARD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: COTAS, ARLENE I
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: COTAS, ARLENE IGNACIO
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
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: COTAS, ARLENE IGNACIO
License/Registration Type: Dentist License
License Number: 47062 Primary Status: Current - Active
Address :
2939 Simba Pl
BRENTWOOD CA 94513-5127
CONTRA COSTA COUNTY
