Peninsula Center for Implantology, A Dental Practice of Joe A. Provines, Dmd

License

Licensed by

Dental Board of California

License number

13194

Status

Expired (Delinquent)

First issued

November 29, 2016

Expired

August 31, 2024

Entity type

Organization

Classifications

• Fictitious Name Permit Dental

More from the license record

License type code

4412

Related

Provines Joe (20440)

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