Dental Board of California
Licensing details for: 80421
Name: KETCHERSIDE DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Current - Active
Organization Classification: Corporation
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: KETCHERSIDE, HOMER GARY
License/Registration Type: Dentist License
License Number: 28872 Primary Status: Current - Active
Address :
400 W Stuart AVe
ste.110
REDLANDS CA 92374
SAN BERNARDINO COUNTY
