Dental Board of California
Licensing details for: 3857
Name: PENG, WILLARD JAMES
License Type: Oral Conscious Sedation
Primary Status: Current - Active
Specialty: Adult
Previous Names: PENG, WILLARD J
Address of Record
30520 Rancho California Rd
Suite #A-105
TEMECULA CA 92591-3212
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VISTA SIGNATURE DENTAL DENTAL OFFICE OF DR. WILLARD PENG
License/Registration Type: Fictitious Name Permit
License Number: 18328 Primary Status: Current - Active
Address :
440 S. MELROSE DRIVE., SUITE 100
VISTA CA 92081
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VINEYARD DENTAL CARE DENTAL OFFICE OF W. PENG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16773 Primary Status: Current - Active
Address :
30630 Rancho California Rd
Suite #504
TEMECULA CA 92591-3283
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VINEYARD DENTAL CARE DENTAL OFFICE OF W. PENG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14774 Primary Status: Expired
Address :
30630 RANCHO CALIFORNIA RD STE 504
TEMECULA CA 92591
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: PENG, WILLARD JAMES
License/Registration Type: Dentist License
License Number: 59666 Primary Status: Current - Active
Address :
30520 Rancho California Rd
Suite #A-105
Suite#A-105
TEMECULA CA 92591-3212
RIVERSIDE COUNTY
