Dental Board of California
Licensing details for: 9243
Name: WELLCARE DENTAL GROUP OF LODI, PRACTICE OF HAYASHI DENTAL CORPORA
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: WELLCARE DENTAL GROUP OF LODI
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HAYASHI, RANDALL TOYSON
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: HAYASHI, RANDALL TOYSON
License/Registration Type: Dentist License
License Number: 36765 Primary Status: Current - Active
Address :
8102 Pollard Ave
FAIR OAKS CA 95628-6059
SACRAMENTO COUNTY
