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: PETER O. ESCUTIN, DDS
License/Registration Type: Additional Office Permit
License Number: 9742 Primary Status: Cancelled
Address :
8052 VINELAND AVE.
STE. 109
SIMI VALLEY CA 91352
VENTURA 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: PETER O. ESCUTIN, DDS & DANIEL ESTACIO, DDS
License/Registration Type: Additional Office Permit
License Number: 8312 Primary Status: Cancelled
Address :
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VINELAND FAMILY DENTAL GROUP, ESCUTIN & ESTACIO,
License/Registration Type: Fictitious Name Permit
License Number: 4522 Primary Status: Cancelled
Address :
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES 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: VINELAND FAMILY DENTAL GROUP, ESCUTIN & ESTACIO,
License/Registration Type: Fictitious Name Permit
License Number: 4522 Primary Status: Cancelled
Address :
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: ESCUTIN, PETER ONG
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 666 Primary Status: Cancelled
Address :
40204 ALBANY COURT
TEMECULA CA 92591
RIVERSIDE COUNTY
