Dental Board of California
Licensing details for: 64589
Name: PARK, PAUL
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
6961 Schaefer Ave
CHINO CA 91710-9126
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: PARK AND SAMBANGI DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79593 Primary Status: Current - Active
Address :
6961 SCHAEFER AVE
CHINO CA 91710
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: PAUL PARK, DDS
License/Registration Type: Additional Office Permit
License Number: 81768 Primary Status: Current - Active
Address :
8415 PINE AVENUE, SUITE 180
CHINO CA 91708
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: PARK AND JACKSON DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81142 Primary Status: Cancelled
Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
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: MAYBERRY DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81532 Primary Status: Current - Active
Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF CHINO PRESERVE DENTAL GROUP, PAUL PARK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18520 Primary Status: Current - Active
Address :
8415 PINE AVENUE, SUITE 180
CHINO CA 91708
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHINO SMILES DENTAL GROUP, PARK AND SAMBANGI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17875 Primary Status: Current - Active
Address :
6961 Schaefer Avenue
CHINO CA 91710
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHINO SMILES DENTAL GROUP, PARK AND SAMBANGI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14060 Primary Status: Cancelled
Address :
6961 SCHAEFER AVE
CHINO CA 91710
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HUB PLAZA DENTAL GROUP, MAYBERRY DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17896 Primary Status: Current - Active
Address :
1047 E. HARRIMAN PLACE, SUITE B
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HUB PLAZA DENTAL GROUP, PARK AND JACKSON DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16471 Primary Status: Cancelled
Address :
1047 E. HARRIMAN PLACE SUITE B
SAN BERNARDINO CA 92408
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: HUB PLAZA DENTAL GROUP, PARK AND JACKSON DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16471 Primary Status: Cancelled
Address :
1047 E. HARRIMAN PLACE SUITE B
SAN BERNARDINO CA 92408
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: CHINO SMILES DENTAL GROUP, PARK AND SAMBANGI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17875 Primary Status: Current - Active
Address :
6961 Schaefer Avenue
CHINO CA 91710
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: DENTISTS OF CHINO PRESERVE DENTAL GROUP, PAUL PARK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18520 Primary Status: Current - Active
Address :
8415 PINE AVENUE, SUITE 180
CHINO CA 91708
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: CHINO SMILES DENTAL GROUP, PARK AND SAMBANGI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14060 Primary Status: Cancelled
Address :
6961 SCHAEFER AVE
CHINO CA 91710
SAN BERNARDINO COUNTY
Registered Dental Hygienist Alternative Practice to Dentist
License/Registration Role: Dentist
Related Party Role: Registered Dental Hygienist Alternative Practice
Name: Bernardo, Myrna Cristina Tanedo
License/Registration Type: Registered Dental Hygienist Alternative Practice
License Number: 967 Primary Status: Current - Active
Address Not Disclosed
