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Licensing details for: 7309

Name: STADIUM DENTAL GROUP, ROBERT P. NAKAKI, DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: STADIUM DENTAL GROUP

Address of Record

2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN county
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Issuance Date

January 25, 2008

Expiration Date

May 31, 2011

Current Date / Time

June 6, 2025
2:0:26 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NAKAKI, ROBERT PAUL

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: NAKAKI, ROBERT PAUL

License/Registration Type: Dentist License

License Number: 28963 Primary Status: Current - Active

Address :
2288 DANIELS STREET
MANTECA CA 95337
SAN JOAQUIN COUNTY

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