Dental Board of California
Licensing details for: 20591
Name: ORAL SURGERY PARTNERS REDONDO BY TMJ WESTERNOFF DENTAL GROUP, P.C.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
1706 S Elena Ave Ste A
REDONDO BEACH CA 90277-5715
LOS ANGELES county
Map
License Relationships
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: WESTERNOFF, TRENT HOWARD
License/Registration Type: Dentist License
License Number: 55703 Primary Status: Current - Active
Address :
604 N Sepulveda Blvd
MANHATTAN BEACH CA 90266-5921
