Dental Board of California
Licensing details for: 2673
Name: LAGUNA BEACH DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
31796 S. COAST HIGHWAY
LAGUNA BEACH CA 92677
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BUEHLER, BRIAN DONALD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WILSON, RUSSELL CLAYTON
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BERGQUIST, CRAIG REED
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: WILSON, RUSSELL CLAYTON
License/Registration Type: Dentist License
License Number: 46346 Primary Status: Current - Active
Address :
7005 Atascadero Ave
ATASCADERO CA 93422-4431
SAN LUIS OBISPO COUNTY
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: BERGQUIST, CRAIG REED
License/Registration Type: Dentist License
License Number: 29913 Primary Status: Expired
Address :
909 Canyon View Dr
LAGUNA BEACH CA 92651-2612
ORANGE COUNTY
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: BUEHLER, BRIAN DONALD
License/Registration Type: Dentist License
License Number: 38166 Primary Status: Current - Active
Address :
943 Pico Ste.A
SAN CLEMENTE CA 92673
ORANGE COUNTY
