Dental Board of California
Licensing details for: 47886
Name: ESTACIO, DANIEL TORIBIO
License Type: Dentist
Primary Status: Current - Active
Address of Record
27310 ROSE MALLOW LN
SANTA CLARITA CA 91387
LOS ANGELES 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: 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: ESTACIO, DANIEL TORIBIO
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 474 Primary Status: Cancelled
Address :
27310 Rose Mallow Ln
SANTA CLARITA CA 91387-6953
LOS ANGELES COUNTY
PMS 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: Pediatric Minimal Sedation Permit
Name: ESTACIO, DANIEL TORIBIO
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 226 Primary Status: Current - Active
Address :
1140 E. CHEVY CHASE DR.
GLENDALE CA 91205
LOS ANGELES COUNTY
