Dental Board of California
Licensing details for: 52164
Name: WOLFRAM, STEVEN MARK
License Type: Dentist
Primary Status: Current - Active
Address of Record
11834 BRYANT STREET
SUITE 104
YUCAIPA CA 92399
SAN BERNARDINO 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: STEVEN WOLFRAM, DDS
License/Registration Type: Additional Office Permit
License Number: 80749 Primary Status: Current - Active
Address :
78461 CA-111
LA QUINTA CA 92253
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: WOLFRAM DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81361 Primary Status: Current - Active
Address :
29941 AVENTURA
RANCHO SANTA MARGARI CA 92688
ORANGE 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: STEVEN WOLFRAM, DDS
License/Registration Type: Additional Office Permit
License Number: 82011 Primary Status: Current - Active
Address :
23731 EL TORO RD D
LAKE FOREST CA 92630
ORANGE 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: SM WOLFRAM, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 81263 Primary Status: Current - Active
Address :
42500 BOB HOPE DR STE 1
RANCHO MIRAGE CA 92270
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: MOUNTAINSIDE DENTAL GROUP, DENTAL OFFICE OF SM WOLFRAM, DDS
License/Registration Type: Fictitious Name Permit
License Number: 17286 Primary Status: Current - Active
Address :
42500 BOB HOPE DR., SUITE 1
RANCHO MIRAGE CA 92270-4429
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: MOUNTAINSIDE DENTAL GROUP, PRACTICE OF WOLFRAM DENTAL CORPORATION, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16194 Primary Status: Current - Active
Address :
78-461 CA-111
LA QUINTA CA 92553
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: MOUTAINSIDE DENTAL GROUP, PRACTICE OF STEVEN WOLFRAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 19252 Primary Status: Current - Active
Address :
23731 EL TORO ROAD, UNIT D
LAKE FOREST CA 92360
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: MOUNTAINSIDE DENTAL GROUP PRACTICE OF WOLFRAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17498 Primary Status: Current - Active
Address :
29941 AVENTURA #B
RANCHO SANTA MARGARI CA 92688
ORANGE 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: MOUNTAINSIDE DENTAL CARE, A DENTAL PRACTICE OF
License/Registration Type: Fictitious Name Permit
License Number: 5050 Primary Status: Current - Active
Address :
11834 BRYANT ST
YUCAIPA CA 92399
SAN BERNARDINO COUNTY
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: GIDLOF, BETTY ANNA
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 451 Primary Status: Current - Active
Address Not Disclosed
