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Licensing details for: 7123

Name: RIVER CITY DENTAL GROUP, KIM AND RODGERS DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: FAIR OAKS DENTAL ASSOCIATES

Address of Record

8908 MADISON AVE.
FAIR OAKS CA 95628
SACRAMENTO county
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Issuance Date

October 15, 2007

Expiration Date

August 31, 2011

Current Date / Time

June 7, 2025
2:31:22 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: RODGERS, CHARLES FREDERICK

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: RODGERS, CHARLES FREDERICK

License/Registration Type: Dentist License

License Number: 35324 Primary Status: Current - Active

Address :
131 W Ontario Ave
Suite 103
CORONA CA 92882-5274
RIVERSIDE COUNTY

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