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Licensing details for: 16773

Name: VINEYARD DENTAL CARE DENTAL OFFICE OF W. PENG DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: W.PENG Dental Corporation

Address of Record

30630 Rancho California Rd
Suite #504
California
TEMECULA CA 92591-3283
RIVERSIDE county
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Practice Location

30630 Rancho California Rd
Suite #504
TEMECULA CA 92591-3283
RIVERSIDE county
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Issuance Date

September 21, 2021

Expiration Date

August 31, 2025

Current Date / Time

June 7, 2025
3:31:15 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PENG, WILLARD JAMES

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: PENG, WILLARD JAMES

License/Registration Type: Dentist License

License Number: 59666 Primary Status: Current - Active

Address :
30520 Rancho California Rd
Suite #A-105
Suite#A-105
TEMECULA CA 92591-3212
RIVERSIDE COUNTY

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