Dental Board of California
Licensing details for: 2634
Name: CHANG, ANDREW ANCHU
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CANYON SPRINGS DENTAL GROUP PENAFLORIDA DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15251 Primary Status: Current - Active
Address :
2878 CAMPUS PKWY., SUITE 1
RIVERSIDE CA 92507
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CANYON SPRINGS DENTAL GROUP DAVID CARLISLE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13408 Primary Status: Cancelled
Address :
2878 CAMPUS PKWY STE 1
RIVERSIDE CA 92507
RIVERSIDE COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: CHANG, ANDREW ANCHU
License/Registration Type: Dentist License
License Number: 60298 Primary Status: Current - Active
Address :
2878 Campus Pkwy
STE 1
RIVERSIDE CA 92507-0966
RIVERSIDE COUNTY
