Dental Board of California
Licensing details for: 2813
Name: STADIUM DENTAL CARE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Address of Record
8590 RIO SAN DIEGO DRIVE #110
SAN DIEGO CA 92108
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MARTINEZ, CHRISTIE LYNN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DOMBROW, DONALD R
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: MARTINEZ, CHRISTIE LYNN
License/Registration Type: Dentist License
License Number: 46495 Primary Status: Current - Active
Address :
305 Walnut Ave
SAN DIEGO CA 92103-4904
SAN DIEGO 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: DOMBROW, DONALD R
License/Registration Type: Dentist License
License Number: 18311 Primary Status: Cancelled
Address :
6071 DEERFORD ROW
SAN DIEGO CA 92037
SAN DIEGO COUNTY
