Dental Board of California
Licensing details for: 103114
Name: SCOTT, ERIC MICHAEL
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by Residency
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: SCOTT AND KANSAGRA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80728 Primary Status: Current - Active
Address :
5685 ALTON PKWY.
IRVINE CA 92618
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF IRVINE DENTAL GROUP, SCOTT AND KANSAGRA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16156 Primary Status: Current - Active
Address :
5685 ALTON PKWY.
IRVINE CA 92618
ORANGE 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 IRVINE DENTAL GROUP, SCOTT AND KANSAGRA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16156 Primary Status: Current - Active
Address :
5685 ALTON PKWY.
IRVINE CA 92618
ORANGE COUNTY
