Dental Board of California
Licensing details for: 22301
Name: VANDERSLOOT, RALPH PETER
License Type: Dentist
Primary Status: Expired
Secondary Status: Radiation Safety Certification
Address of Record
5700 STONERIDGE MALL RD
SUITE 290
PLEASANTON CA 94566
ALAMEDA county
Map
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: RALPH P VANDERSLOOT
License/Registration Type: Additional Office Permit
License Number: 4987 Primary Status: Cancelled
Address :
250 JUANA AVENUE
SAN LEANDRO CA 94577
ALAMEDA COUNTY
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: ERICKSON,SANTUCCI,MAASS,MACKENZIE,GRIGGS & VANDERSLOOT
License/Registration Type: Additional Office Permit
License Number: 5158 Primary Status: Cancelled
Address :
15051 HESPERIAN BLVD
SAN LEANDRO CA 94578
ALAMEDA COUNTY
CS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Conscious Sedation Permit
Name: VANDERSLOOT, RALPH PETER
License/Registration Type: Conscious Sedation Permit
License Number: 198 Primary Status: Cancelled
Address :
5700 STONERIDGE MALL ROAD #290
PLEASANTON CA 94588
ALAMEDA 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: CREATIVE DIMENSIONS IN DENTISTRY DENTAL GROUP ERICKSON,DDS ET AL
License/Registration Type: Fictitious Name Permit
License Number: 885 Primary Status: Cancelled
Address :
15051 HESPERIAN BLVD
SAN LEANDRO CA 94578
ALAMEDA 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: CREATIVE DIMENSIONS IN DENTISTRY
License/Registration Type: Fictitious Name Permit
License Number: 838 Primary Status: Cancelled
Address :
250 JUANA AVENUE
SAN LEANDRO CA 94577
ALAMEDA COUNTY
