Dental Board of California
Licensing details for: 30605
Name: MACKENZIE, GEORGE DAVID
License Type: Dentist
Primary Status: Expired
Address of Record
3215 Gold Ct
LAFAYETTE CA 94549-5405
CONTRA COSTA 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: 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
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,GUASTELLA & ALVARO
License/Registration Type: Additional Office Permit
License Number: 5878 Primary Status: Cancelled
Address :
345 ESTUDILLO AVE.
SAN LEANDRO CA 94577
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: MACKENZIE, GEORGE DAVID
License/Registration Type: Conscious Sedation Permit
License Number: 125 Primary Status: Cancelled
Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
ALAMEDA COUNTY
FNP Owners
License/Registration Role: Owners
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 Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CREATIVE DIMENSIONS IN DENTISTRY
License/Registration Type: Fictitious Name Permit
License Number: 837 Primary Status: Current - Active
Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
ALAMEDA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CREATIVE DIMENSIONS IN DENTISTRY, ERICKSON, SANTUCCI,
License/Registration Type: Fictitious Name Permit
License Number: 1455 Primary Status: Expired
Address :
345 ESTUDILLO AVENUE
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, ERICKSON, SANTUCCI,
License/Registration Type: Fictitious Name Permit
License Number: 1455 Primary Status: Expired
Address :
345 ESTUDILLO AVENUE
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: 837 Primary Status: Current - Active
Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
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
