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Licensing details for: 7758

Name: PERSONALIZED DENTAL CARE, ROSEVILLE * LINCOLN, DENTAL GROUP OF RI

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

4000 FOOTHILLS BLVD STE 126
ROSEVILLE CA 95747
PLACER county
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Issuance Date

November 4, 2008

Expiration Date

January 31, 2019

Current Date / Time

June 6, 2025
1:34:10 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: HERMAN, TIMOTHY JAMES

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: 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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