Dental Board of California
Licensing details for: 874
Name: THOMPSON, MARLENE MAVILLA
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Previous Names: THOMPSON, MARLENE MAVILA ❖ THOMPSON, MARLENE M
Address of Record
1018 W EL NORTE PKWY
ESCONDIDO CA 92026
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: NC FAMILY DENTAL, DENTAL OFFICE, MARLENE THOMPSON, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 10605 Primary Status: Expired
Address :
988 W. EL NORTE PARKWAY
ESCONDIDO CA 92026
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: EL CAMINO SQUARE DENTAL, DENTAL OFFICE, MARLENE M. THOMPSON, DDS,
License/Registration Type: Fictitious Name Permit
License Number: 10607 Primary Status: Cancelled
Address :
191 N. EL CAMINO REAL, STE. 209
ENCINITAS CA 92024
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: AVAH DENTAL OFFICE MARLENE M. THOMPSON D.D.S, INC.
License/Registration Type: Fictitious Name Permit
License Number: 16462 Primary Status: Current - Active
Address :
1001 W SAN MARCOS BLVD #106C
SAN MARCOS CA 92078
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BROADWAY SMILES, DENTAL PRACTICE OF DR. MARLENE THOMPSON
License/Registration Type: Fictitious Name Permit
License Number: 11839 Primary Status: Expired
Address :
126 W EL NORTE PKWY
ESCONDIDO CA 92026
SAN DIEGO 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: THOMPSON, MARLENE MAVILLA
License/Registration Type: Dentist License
License Number: 50382 Primary Status: Current - Active
Address :
1001 W San Marcos Blvd
106C
SAN MARCOS CA 92078-4012
SAN DIEGO COUNTY
