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Licensing details for: 12041

Name: SUMABAT DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

43990 GOLF CENTER PARKWAY
UNIT B4
INDIO CA 92203
RIVERSIDE county
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Practice Location

43990 GOLF CENTER PARKWAY
UNIT B4
INDIO CA 92203-5000
RIVERSIDE county
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Issuance Date

October 14, 2015

Expiration Date

August 31, 2026

Current Date / Time

June 6, 2025
10:24:53 PM

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: SUMABAT, RAMON RICARDO

License/Registration Type: Dentist License

License Number: 42426 Primary Status: Current - Active

Address :
285 S Palm Canyon Dr
SUITE D-7
PALM SPRINGS CA 92262-6355
RIVERSIDE COUNTY

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