Dental Board of California
Licensing details for: 10984
Name: JACK GORMAN DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
2465 IRON POINT ROAD
FOLSOM CA 95630
SACRAMENTO county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Additional Office Permit
Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Name: WATANABE, BRYAN KAZUMI
License/Registration Type: Dentist License
License Number: 40130 Primary Status: Current - Active
Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY
