Dental Board of California
Licensing details for: 8905
Name: SMILES DENTAL SPA, DENTAL GROUP OF SHAILAJA MENON, DDS, INC.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Previous Names: SMILES DENTAL SPA
Address of Record
1431 N. TRACY BLVD.
TRACY CA 95376
SAN JOAQUIN county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MENON, SHAILAJA N
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: MENON, SHAILAJA N
License/Registration Type: Dentist License
License Number: 50955 Primary Status: Current - Active
Address :
2087 Laguna Creek Ln
PLEASANTON CA 94566-3407
ALAMEDA COUNTY
