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Licensing details for: 666

Name: ESCUTIN, PETER ONG

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

40204 ALBANY COURT
TEMECULA CA 92591
RIVERSIDE county
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Issuance Date

February 23, 2004

Expiration Date

October 31, 2011

Current Date / Time

June 7, 2025
10:29:12 AM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: VINELAND FAMILY DENTAL GROUP, ESCUTIN & ESTACIO,

License/Registration Type: Fictitious Name Permit

License Number: 4522 Primary Status: Cancelled

Address :
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES COUNTY

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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: ESCUTIN, PETER ONG

License/Registration Type: Dentist License

License Number: 38992 Primary Status: Current - Active

Address :
23119 Soboba Rd
SAN JACINTO CA 92583-2903
RIVERSIDE COUNTY

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