Dental Board of California
Licensing details for: 28354
Name: LOITZ, GREG ALLEN
License Type: Dentist
Primary Status: Cancelled
Address of Record
33 PALMA AVENUE
LA SELVA BEACH CA 95076-1729
SANTA CRUZ county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: THE SPECIALTY DENTAL CARE GROUP, PEDER H. HAMILTON, DDS
License/Registration Type: Fictitious Name Permit
License Number: 1352 Primary Status: Cancelled
Address :
15000 LOS GATOS BLVD
LOS GATOS CA 95032
SANTA CLARA 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: THE SPECIALTY DENTAL CARE GROUP, PEDER H. HAMILTON, DDS
License/Registration Type: Fictitious Name Permit
License Number: 1352 Primary Status: Cancelled
Address :
15000 LOS GATOS BLVD
LOS GATOS CA 95032
SANTA CLARA COUNTY
GA to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: General Anesthesia Permit
Name: LOITZ, GREG ALLEN
License/Registration Type: General Anesthesia Permit
License Number: 711 Primary Status: Cancelled
Address :
33 PALMA AVENUE
LA SELVA BEACH CA 95076
SANTA CRUZ COUNTY
