Dental Board of California
Licensing details for: 104589
Name: SLADE, MICHELLE GONZALES
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: MICHELLE SLADE, DDS
License/Registration Type: Additional Office Permit
License Number: 82285 Primary Status: Current - Active
Address :
27830 Greenspot Road, Suite 3
HIGHLAND CA 92346
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: Greenspot Crossings Dentistry, Dental Group of Greenspot Crossings Dentistry, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20161 Primary Status: Current - Active
Address :
27830 Greenspot Road, Suite 3
HIGHLAND CA 92346
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: La Verne Dental Group
License/Registration Type: Fictitious Name Permit
License Number: 20267 Primary Status: Current - Active
Address :
2216 Foothill Blvd
LA VERNE CA 91750
