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Licensing details for: 5966

Name: PERSONALIZED DENTAL CARE ROSEVILLE * LINCOLN DENTAL GROUP,

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

685 TWELVE BRIDGES DR
STE E
LINCOLN CA 95648
PLACER county
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Issuance Date

February 9, 2006

Expiration Date

January 31, 2009

Current Date / Time

December 13, 2025
11:45:44 AM

License Relationships

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 :
4000 Foothills Blvd
Suite 126
ROSEVILLE CA 95747-7251
PLACER COUNTY

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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 95648-8473
PLACER COUNTY

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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

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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

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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

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