Dental Board of California
Licensing details for: 62073
Name: BOTROUS, MATTA JOSEPH MATTA
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Previous Names: BOTROUS, MATTA J
Address of Record
10590 TOWN CENTER DR
SUITE 180
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: TALENT DENTAL DENTAL GROUP OF MATTA BOTROUS, DDS, INC
License/Registration Type: Fictitious Name Permit
License Number: 13496 Primary Status: Current - Active
Address :
10590 TOWN CENTER DR STE 180
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: TALENT DENTAL DENTAL GROUP OF MATTA BOTROUS, DDS, INC
License/Registration Type: Fictitious Name Permit
License Number: 13496 Primary Status: Current - Active
Address :
10590 TOWN CENTER DR STE 180
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
