Dental Board of California
Licensing details for: 16520
Name: MISSION DENTAL PRACTICE OF JUSTIN W. NICHOLS, DDS, INC.
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: NICHOLS, JUSTIN WILLIAM
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: NICHOLS, JUSTIN WILLIAM
License/Registration Type: Dentist License
License Number: 100587 Primary Status: Expired
Address :
2745 Pine Creek Cir
FULLERTON CA 92835-2937
ORANGE COUNTY
