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Licensing details for: 11018

Name: ALPHA DENTAL, OFFICE OF ROY J. VEGTER, A DENTAL CORPORAITON

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

4276 54TH PLACE SUITE D
SAN DIEGO CA 92115
SAN DIEGO county
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Practice Location

4276 54TH PLACE SUITE D
SAN DIEGO CA 92115
SAN DIEGO county
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Issuance Date

January 23, 2014

Expiration Date

July 31, 2024

Current Date / Time

June 6, 2025
2:4:32 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: VEGTER, ROY J

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: VEGTER, ROY J

License/Registration Type: Dentist License

License Number: 58955 Primary Status: Current - Active

Address :
4276 54th Pl
suite d
SAN DIEGO CA 92115-6011
SAN DIEGO COUNTY

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