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Licensing details for: 172

Name: EWING, SCOTT GAVIN

License Type: Moderate Sedation Permit

Primary Status: Current - Active

Address of Record

901 Sunvalley Blvd Ste 240
CONCORD CA 94520-5817
CONTRA COSTA county
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Practice Location

901 Sunvalley Blvd Ste 240
CONCORD CA 94520-5817
CONTRA COSTA county
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Issuance Date

June 6, 2023

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:3:39 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: SMILE MAKERS DENTAL CARE DENTAL PRACTICE OF S. GAVIN EWING, DDS, INC.

License/Registration Type: Fictitious Name Permit

License Number: 15004 Primary Status: Current - Active

Address :
901 SUN VALLEY BLVD SUITE 240
CONCORD CA 94520
CONTRA COSTA COUNTY

Map

MS to DDS or OMS or SP

License/Registration Role: Moderate Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: EWING, SCOTT GAVIN

License/Registration Type: Dentist License

License Number: 64781 Primary Status: Current - Active

Address :
901 Sunvalley Blvd Ste 240
CONCORD CA 94520-5817
CONTRA COSTA COUNTY

Map

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