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Licensing details for: 10168

Name: WINERY ESTATE DENTAL GROUP, GHAZAL AND HSIEH DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

7369 Day Creek Blvd Ste F-103
RANCHO CUCAMONGA CA 91739-8020
SAN BERNARDINO county
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Practice Location

7369 DAY CREEK BOULEVARD, STE. F-103
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Issuance Date

October 4, 2012

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:11:10 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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