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Licensing details for: 17354

Name: GENTLE DENTAL DEL LAGO - A DENTAL OFFICE OF COX DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: COX DENTAL CORPORATION

Address of Record

9800 S La Cienega Blvd
Ste 800
INGLEWOOD CA 90301
LOS ANGELES county
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Practice Location

3440 Del Lago Blvd
Ste 5
ESCONDIDO CA 92029
SAN DIEGO county
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Issuance Date

September 30, 2022

Expiration Date

August 31, 2026

Current Date / Time

June 6, 2025
2:12:35 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: COX, WILLIAM JOSEPH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHAUDHRY, MANU

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: COX, WILLIAM JOSEPH

License/Registration Type: Dentist License

License Number: 26160 Primary Status: Current - Active

Address :
4950 BARRANCA PKWY #105
IRVINE CA 92604
ORANGE COUNTY

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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: CHAUDHRY, MANU

License/Registration Type: Dentist License

License Number: 58484 Primary Status: Current - Active

Address :
24239 Hesperian Blvd
HAYWARD CA 94545-1526
ALAMEDA COUNTY

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