Dental Board of California
Licensing details for: 10607
Name: EL CAMINO SQUARE DENTAL, DENTAL OFFICE, MARLENE M. THOMPSON, DDS,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: THOMPSON, MARLENE MAVILLA
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: THOMPSON, MARLENE MAVILLA
License/Registration Type: Dentist License
License Number: 50382 Primary Status: Current - Active
Address :
1001 W San Marcos Blvd
106C
SAN MARCOS CA 92078-4012
SAN DIEGO COUNTY
