Dental Board of California
Licensing details for: 104037
Name: ENCISO, JORGE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
13554 DOUGLAS ST.
YUCAIPA CA 92399
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTASTIC DENTAL GROUP OF JORGE ENCISO, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16606 Primary Status: Expired
Address :
34366 YUCAIPA BLVD STE K
YUCAIPA CA 92399
SAN BERNARDINO 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: DENTASTIC DENTAL GROUP OF JORGE ENCISO, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16606 Primary Status: Expired
Address :
34366 YUCAIPA BLVD STE K
YUCAIPA CA 92399
SAN BERNARDINO COUNTY
