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Licensing details for: 5158

Name: ERICKSON,SANTUCCI,MAASS,MACKENZIE,GRIGGS & VANDERSLOOT

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

15051 HESPERIAN BLVD
SAN LEANDRO CA 94578
ALAMEDA county
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Issuance Date

November 13, 1992

Expiration Date

July 31, 1998

Current Date / Time

June 6, 2025
2:26:6 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: SANTUCCI, EUGENE THOMAS

License/Registration Type: Dentist License

License Number: 23141 Primary Status: Current - Active

Address :
245 LOWELL ST
REDWOOD CITY CA 94062
SAN MATEO COUNTY

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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: MAASS, ROBERT MICHAEL

License/Registration Type: Dentist License

License Number: 25419 Primary Status: Expired

Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
ALAMEDA COUNTY

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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: MACKENZIE, GEORGE DAVID

License/Registration Type: Dentist License

License Number: 30605 Primary Status: Expired

Address :
3215 Gold Ct
LAFAYETTE CA 94549-5405
CONTRA COSTA COUNTY

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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: VANDERSLOOT, RALPH PETER

License/Registration Type: Dentist License

License Number: 22301 Primary Status: Expired

Address :
5700 STONERIDGE MALL RD
SUITE 290
PLEASANTON CA 94566
ALAMEDA COUNTY

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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: GRIGGS, REGINALD ARNOLD

License/Registration Type: Dentist License

License Number: 31619 Primary Status: Current - Active

Address :
20265 Lake Chabot Rd
CASTRO VALLEY CA 94546
ALAMEDA COUNTY

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