Dental Board of California
Licensing details for: 13697
Name: FLETCHER PARKWAY FAMILY DENTAL GROUP, NORDQUIST & NICHOLSON PROFESSIONAL DENTAL CORPORATION
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: NICHOLSON, CHARLES SIMMS III
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NORDQUIST, WILLIAM DEAN
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: NORDQUIST, WILLIAM DEAN
License/Registration Type: Dentist License
License Number: 25281 Primary Status: Current - Active
Address :
236 Jamacha Rd
EL CAJON CA 92019-2366
SAN DIEGO COUNTY
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: NICHOLSON, CHARLES SIMMS III
License/Registration Type: Dentist License
License Number: 20425 Primary Status: Expired
Address :
236 Jamacha Rd
101
EL CAJON CA 92019-2366
SAN DIEGO COUNTY
