Dental Board of California
Licensing details for: 49350
Name: KRAKOWIAK, PETER ADAM
License Type: Dentist
Primary Status: Current - Active
Address of Record
25460 Medical Center Dr
201
MURRIETA CA 92562-5966
RIVERSIDE 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 A KRAKOWIAK, D.M.D., A PROFESSIONAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81185 Primary Status: Current - Active
Address :
111 W MISSION RD #A
FALLBROOK CA 92028
SAN DIEGO 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 A. KRAKOWIAK, DMD, A PROF. DENTAL CORP.
License/Registration Type: Additional Office Permit
License Number: 10222 Primary Status: Cancelled
Address :
5256 S. MISSION RD.
STE. 1103
BONSALL CA 92003
SAN DIEGO 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 KRAKOWIAK DMD, A PROFESSIONAL DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81184 Primary Status: Current - Active
Address :
265 SAN JACINTO RIVER RD #101
LAKE ELSINORE CA 92530
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAKESHORE ORAL & MAXILLOFACIAL SURGERY SPECIALTY, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 11609 Primary Status: Cancelled
Address :
25460 MEDICAL CENTER DR #201
MURRIETA CA 92562
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAKESHORE ORAL & MAXILLOFACIAL SURGERY, SPECIALTY DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 6388 Primary Status: Expired
Address :
265 SAN JACINTO RIVER RD., STE. 101
LAKE ELSINORE CA 92530
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAKESHORE ORAL & MAXILLOFACIAL SURGERY SPECIALTY, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 11610 Primary Status: Current - Active
Address :
111 W MISSION RD STE A
FALLBROOK CA 92028
SAN DIEGO 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: LAKESHORE ORAL & MAXILLOFACIAL SURGERY SPECIALTY, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 11609 Primary Status: Cancelled
Address :
25460 MEDICAL CENTER DR #201
MURRIETA CA 92562
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: LAKESHORE ORAL & MAXILLOFACIAL SURGERY SPECIALTY, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 11610 Primary Status: Current - Active
Address :
111 W MISSION RD STE A
FALLBROOK CA 92028
SAN DIEGO 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: LAKESHORE ORAL & MAXILLOFACIAL SURGERY, SPECIALTY DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 6388 Primary Status: Expired
Address :
265 SAN JACINTO RIVER RD., STE. 101
LAKE ELSINORE CA 92530
RIVERSIDE 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: KRAKOWIAK, PETER ADAM
License/Registration Type: General Anesthesia Permit
License Number: 1271 Primary Status: Current - Active
Address :
25460 Medical Center Dr
201
MURRIETA CA 92562-5966
RIVERSIDE COUNTY
