Dental Board of California
Licensing details for: 63993
Name: ROQUIZ, DAVID RAY
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
11132 MORNINGSTAR PL
LOMA LINDA CA 92354
SAN BERNARDINO 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: ROQUIZ AND DHAMA DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81206 Primary Status: Current - Active
Address :
3955 BEDFORD CANYON ROAD, SUITE 101
CORONA CA 92883
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BEDFORD MODERN DENTISTRY DENTAL GROUP, ROQUIZ AND DHAMA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17291 Primary Status: Current - Active
Address :
3955 BEDFORD CANYON ROAD., SUITE 101
CORONA CA 92883
RIVERSIDE 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: BEDFORD MODERN DENTISTRY DENTAL GROUP, ROQUIZ AND DHAMA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17291 Primary Status: Current - Active
Address :
3955 BEDFORD CANYON ROAD., SUITE 101
CORONA CA 92883
RIVERSIDE COUNTY
