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Licensing details for: 11196

Name: KIDS DENTAL CARE, DENTAL OFFFICE OF BRUCE B. BAKER, DMD, A PROFES

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

42210 LYNDIE LANE
SUITE 100
TEMECULA CA 92591
RIVERSIDE county
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Practice Location

42210 LYNDIE LANE
SUITE 100
TEMECULA CA 92591
RIVERSIDE county
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Issuance Date

April 8, 2014

Expiration Date

March 31, 2022

Current Date / Time

June 7, 2025
4:6:58 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAKER, BRUCE BAKHSHI

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: BAKER, BRUCE BAKHSHI

License/Registration Type: Dentist License

License Number: 32267 Primary Status: Voluntary Surrendered

Address :
PO BOX 669
POWAY CA 92074
SAN DIEGO COUNTY

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