Dental Board of California
Licensing details for: 15280
Name: ANTELOPE VALLEY DENTAL SURGERY CENTER DENTAL GROUP OF SNOW, NAKANO & LOPEZ PROFESSIONAL DENTAL CORPORATION
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: SNOW, GILBERT H
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LOPEZ, ALEX DIAZ
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NAKANO, JONATHAN KIYOMI
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: LOPEZ, ALEX DIAZ
License/Registration Type: Dentist License
License Number: 44012 Primary Status: Current - Active
Address :
868 Auto Center Dr
Suite A
PALMDALE CA 93551-4690
LOS ANGELES 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: SNOW, GILBERT H
License/Registration Type: Dentist License
License Number: 19385 Primary Status: Current - Active
Address :
868 AUTO CENTER DR. SUITE C
PALMDALE CA 93550
LOS ANGELES 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: NAKANO, JONATHAN KIYOMI
License/Registration Type: Dentist License
License Number: 53248 Primary Status: Current - Active
Address :
61 Long Ct Ste 101
THOUSAND OAKS CA 91360-6083
VENTURA COUNTY
