Dental Board of California
Licensing details for: 53059
Name: DIZON JR, SANDY INTON
License Type: Dentist
Primary Status: Current - Active
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTRY AT EMPIRE LAKES, DENTAL PRACTICE OF SANDY I. DIZON JR, DDS
License/Registration Type: Fictitious Name Permit
License Number: 13379 Primary Status: Current - Active
Address :
9640 Milliken Ave
104
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO 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: DENTISTRY AT EMPIRE LAKES, DENTAL PRACTICE OF SANDY I. DIZON JR, DDS
License/Registration Type: Fictitious Name Permit
License Number: 13379 Primary Status: Current - Active
Address :
9640 Milliken Ave
104
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
