Dental Board of California
Licensing details for: 9288
Name: TERRA VISTA DENTAL CARE, DENTAL OFFICE OF KEYURKUMAR PATEL, DDS.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: TERRA VISTA DENTAL CARE
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PATEL, KEYURKUMAR RATILAL
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: PATEL, KEYURKUMAR RATILAL
License/Registration Type: Dentist License
License Number: 54570 Primary Status: Deceased
Address :
7211 Haven Ave
suite D
RANCHO CUCAMONGA CA 91701-6064
SAN BERNARDINO COUNTY
