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Licensing details for: 7704

Name: WATANABE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

23905 CLINTON KEITH RD, #106
WILDOMAR CA 92595
RIVERSIDE county
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Issuance Date

June 12, 2002

Expiration Date

December 31, 2005

Current Date / Time

June 6, 2025
11:21:10 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: 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

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