Dental Board of California
Licensing details for: 63500
Name: ALFONSO, ANTONIO ANDREW
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
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: ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79213 Primary Status: Cancelled
Address :
20258 US Highway 18 Ste 400
APPLE VALLEY CA 92307-6197
SAN BERNARDINO 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: ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80211 Primary Status: Cancelled
Address :
20258 US HWY. 18 SUITE 400
APPLE VALLEY CA 92307
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PARKWAY DENTAL GROUP ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13309 Primary Status: Cancelled
Address :
20258 US HIGHWAY 18, SUITE 400
APPLE VALLEY CA 92307
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PARKWAY DENTAL GROUP ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15205 Primary Status: Cancelled
Address :
20258 US HWY. 18, SUITE 400
APPLE VALLEY CA 92307
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: PARKWAY DENTAL GROUP ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15205 Primary Status: Cancelled
Address :
20258 US HWY. 18, SUITE 400
APPLE VALLEY CA 92307
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: PARKWAY DENTAL GROUP ALFONSO AND LOPEZ DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13309 Primary Status: Cancelled
Address :
20258 US HIGHWAY 18, SUITE 400
APPLE VALLEY CA 92307
SAN BERNARDINO COUNTY
