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Licensing details for: 11458

Name: FRATT DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

12761 MORENO BEACH DR. SUITE 103
MORENO VALLEY CA 92555
RIVERSIDE county
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Practice Location

12761 MORENO BEACH DR. SUITE 103
MORENO VALLEY CA 92555
RIVERSIDE county
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Issuance Date

June 24, 2014

Expiration Date

July 31, 2015

Current Date / Time

June 7, 2025
7:14:44 AM

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: FRATT, DENNIS R

License/Registration Type: Dentist License

License Number: 24779 Primary Status: Expired

Address :
1005 BAYSIDE COVE
NEWPORT BEACH CA 92660
ORANGE COUNTY

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