Dental Board of California
Licensing details for: 102692
Name: NAMM, JUSTIN KIRK
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: JUSTIN NAMM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81513 Primary Status: Current - Active
Address :
1221 STATE ST SUITE D
SAN JACINTO CA 92583
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF SAN JACINTO DENTAL GROUP, JUSTIN NAMM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17644 Primary Status: Current - Active
Address :
1221 STATE ST SUITE D
SAN JACINTO CA 92583
RIVERSIDE COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF SAN JACINTO DENTAL GROUP, JUSTIN NAMM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17644 Primary Status: Current - Active
Address :
1221 STATE ST SUITE D
SAN JACINTO CA 92583
RIVERSIDE COUNTY
