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: BRYAN K WATANABE, A PROFESSIONAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 8734 Primary Status: Cancelled
Address :
10286 INDIANA AVENUE
RIVERSIDE CA 92503
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GATEWAY DENTAL GROUP OF RIVERSIDE, BRYAN K WATANABE,
License/Registration Type: Fictitious Name Permit
License Number: 5900 Primary Status: Cancelled
Address :
10286 INDIANA AVE
RIVERSIDE CA 92503
RIVERSIDE 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: GATEWAY DENTAL GROUP OF RIVERSIDE, BRYAN K WATANABE,
License/Registration Type: Fictitious Name Permit
License Number: 5900 Primary Status: Cancelled
Address :
10286 INDIANA AVE
RIVERSIDE CA 92503
RIVERSIDE COUNTY
