Dental Board of California
Licensing details for: 63663
Name: WALKER, CLINT CODY
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
270 E 17th St
Ste 15
COSTA MESA CA 92627-3861
ORANGE 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: CLINT WALKER DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79758 Primary Status: Current - Active
Address :
270 E. 17TH STREET, STE 15
COSTA MESA CA 92627
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: 17TH STREET MODERN DENTISTRY DENTAL GROUP CLINT WALKER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14412 Primary Status: Current - Active
Address :
270 E. 17TH STREET, STE 15
COSTA MESA CA 92627
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: 17TH STREET MODERN DENTISTRY DENTAL GROUP CLINT WALKER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14412 Primary Status: Current - Active
Address :
270 E. 17TH STREET, STE 15
COSTA MESA CA 92627
ORANGE COUNTY
