Dental Board of California
Licensing details for: 11687
Name: GOLDEN WEST DENTISTRY, PRACTICE OF CALVILLO & PENALBA DENTAL CORP
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PENALBA, WILBERTO ISAAC
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: PENALBA, WILBERTO ISAAC
License/Registration Type: Dentist License
License Number: 60504 Primary Status: Current - Active
Address :
9922 Sierra Ave
FONTANA CA 92335-6721
SAN BERNARDINO COUNTY
