Dental Board of California
Licensing details for: 5965
Name: PERSONALIZED DENTAL CARE ROSEVILLE * LINCOLN DENTAL GROUP,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
4000 FOOTHILL BLVD
STE 126
ROSEVILLE CA 95747
PLACER county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SEIDEL, FLAVIANE FERNANDES CHAVES
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ALMASSY, RICHARD A
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MANALOTO, ABDON BAUTISTA JR
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HERMAN, TIMOTHY JAMES
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DRINGENBERG, KAYLA NGUYEN
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: SEIDEL, FLAVIANE FERNANDES CHAVES
License/Registration Type: Dentist License
License Number: 49636 Primary Status: Current - Active
Address :
945 Orchard Creek Ln
200
LINCOLN CA 95648
PLACER 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: ALMASSY, RICHARD A
License/Registration Type: Dentist License
License Number: 23268 Primary Status: Cancelled
Address :
948 GOLD NUGGET CIRCLE
LINCOLN CA 95648
PLACER 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: HERMAN, TIMOTHY JAMES
License/Registration Type: Dentist License
License Number: 36937 Primary Status: Current - Active
Address :
1840 Prairie City Rd
200
FOLSOM CA 95630-9579
SACRAMENTO 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: DRINGENBERG, KAYLA NGUYEN
License/Registration Type: Dentist License
License Number: 50170 Primary Status: Current - Active
Address :
1258 COLOMA WAY
ROSEVILLE CA 95661
PLACER 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: MANALOTO, ABDON BAUTISTA JR
License/Registration Type: Dentist License
License Number: 42934 Primary Status: Current - Active
Address :
1840 Prairie City Road
Suite 200
FOLSOM CA 95630-9579
SACRAMENTO COUNTY
