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Licensing details for: 16019

Name: DENTAL EXPRESS DENTAL GROUP C. ASHMORE CORP.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

15717 BERNARDO HEIGHTS PKWY
SAN DIEGO CA 92128
SAN DIEGO county
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Practice Location

15717 BERNARDO HEIGHTS PKWY
SAN DIEGO CA 92128
SAN DIEGO county
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Issuance Date

September 22, 2020

Expiration Date

May 31, 2024

Current Date / Time

June 6, 2025
2:9:48 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ASHMORE, GLENN CASEY

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: ASHMORE, GLENN CASEY

License/Registration Type: Dentist License

License Number: 63198 Primary Status: Current - Active

Address :
4110 W POINT LOMA BLVD
SAN DIEGO CA 92110
SAN DIEGO COUNTY

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