Dental Board of California
Licensing details for: 57219
Name: BUZZELL, JORDAN NATHANIEL
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
110 TOWN CENTER PARKWAY
Suite A
SANTEE CA 92071
SAN DIEGO 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: PHAM & MAUSETH, DDS, INC.
License/Registration Type: Additional Office Permit
License Number: 79675 Primary Status: Cancelled
Address :
110 Town Center Pkwy
Suite A
SANTEE CA 92071-5801
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: BPM DENTAL PARTNERSHIP
License/Registration Type: Additional Office Permit
License Number: 81131 Primary Status: Current - Active
Address :
110 TOWN CENTER PKWY
SANTEE CA 92071
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SANTEE PEDIATRIC DENTISTRY, DENTAL PRACTICE OF BPM DENTAL PARTNERSHIP
License/Registration Type: Fictitious Name Permit
License Number: 13896 Primary Status: Cancelled
Address :
110 TOWN CENTER PKWY STE A
SANTEE CA 92071
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: SANTEE PEDIATRIC DENTISTRY, DENTAL PRACTICE OF BPM DENTAL PARTNERSHIP
License/Registration Type: Fictitious Name Permit
License Number: 13896 Primary Status: Cancelled
Address :
110 TOWN CENTER PKWY STE A
SANTEE CA 92071
SAN DIEGO 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: BUZZELL, JORDAN NATHANIEL
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3227 Primary Status: Cancelled
Address :
110 TOWN CENTER PARKWAY
Suite A
SANTEE CA 92071
SAN DIEGO 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: BUZZELL, JORDAN NATHANIEL
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 229 Primary Status: Current - Active
Address :
110 TOWNCENTER PKWY, SUITE A
SANTEE CA 92071
SAN DIEGO COUNTY
