Dental Board of California
Licensing details for: 104123
Name: WALTERS, CHRISTOPHER ROBIN
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
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: Grand Terrace Modern Dentistry, Dental Group of Grand Terrace Modern Dentistry, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20243 Primary Status: Current - Active
Address :
22471 Barton Rd
GRAND TERRACE CA 92313
