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Licensing details for: 9104

Name: GUY W. MENDIVIL, DDS, PROFESSIONAL DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: GUY MENDIVIL

Address of Record

985 SOUTH SANTA FE AVE., STE. 8
VISTA CA 92083
SAN DIEGO county
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Issuance Date

July 27, 2006

Expiration Date

November 30, 2010

Current Date / Time

June 7, 2025
8:48:11 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: MENDIVIL, GUY WILLIAM

License/Registration Type: Dentist License

License Number: 29737 Primary Status: Current - Active

Address :
11901 Bolthouse Dr
SUITE 200
BAKERSFIELD CA 93311-8455

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