Dental Board of California
Licensing details for: 11762
Name: KENSINGTON DENTAL GROUP, LE AND PHAM DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: KENSINGTON DENTAL GROUP LE AND PHAM DENTAL CORPORATION
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WATANABE, LYNDA CAROL
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: WATANABE, LYNDA CAROL
License/Registration Type: Dentist License
License Number: 40116 Primary Status: Current - Active
Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE COUNTY
