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Licensing details for: 9953

Name: BRENTWOOD SMILES DENTAL GROUP, AMARDEEP GILL, DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: BRENTWOOD SMILES DENTAL GROUP AMARDEEP GILL, D.D.S., INC.

Address of Record

6660 LONE TREE WAY, STE. 7
BRENTWOOD CA 94513
CONTRA COSTA county
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Practice Location

6660 LONE TREE WAY, STE. 7
BRENTWOOD CA 94513
CONTRA COSTA county
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Issuance Date

May 18, 2012

Expiration Date

June 30, 2016

Current Date / Time

June 6, 2025
10:18:49 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHAZAL, CAROLYN G

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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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