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Licensing details for: 8451

Name: WATANABE AND NGUYEN PROFESSIONAL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

36068 HIDDEN SPRINGS RD, STE H
WILDOMAR CA 92595
RIVERSIDE county
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Issuance Date

February 7, 2005

Expiration Date

December 31, 2013

Current Date / Time

June 6, 2025
2:27:26 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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
4443 Candlewood St
LAKEWOOD CA 90712-1736

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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: 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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