Dental Board of California
Licensing details for: 102931
Name: DEWENTER, ALYSSA CATHERINE
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: DEWENTER DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81673 Primary Status: Current - Active
Address :
67760 E. PALM CANYON DRIVE
CATHEDRAL CITY CA 92234
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: PALM CANYON SMILES DENTISTRY DENTAL GROUP, DEWENTER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17996 Primary Status: Current - Active
Address :
67760 E. PALM CANYON DRIVE
CATHEDRAL CITY CA 92234
RIVERSIDE COUNTY



