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Licensing details for: 412

Name: GALLEZ, FABRICE JACQUES

License Type: Moderate Sedation Permit

Primary Status: Current - Active

Address of Record

2581 SAMARITAN DR. STE 310
SAN JOSE CA 95124
SANTA CLARA county
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Practice Location

2581 SAMARITAN DR. STE 310
SAN JOSE CA 95124
SANTA CLARA county
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Issuance Date

April 5, 2024

Expiration Date

May 31, 2026

Current Date / Time

June 6, 2025
7:6:10 PM

License Relationships

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: GALLEZ, FABRICE JACQUES

License/Registration Type: Dentist License

License Number: 48268 Primary Status: Current - Active

Address :
370 W. Dunne Ave
#5
370 W. Dunne Ave, #5
MORGAN HILL CA 95037
SANTA CLARA COUNTY

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