Dental Board of California
Licensing details for: 2863
Name: APPLE VALLEY DENTAL OFFICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
18245 HIGHWAY 18 SUITE 4
APPLE VALLEY CA 92307
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SOE, PYI
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: SOE, PYI
License/Registration Type: Dentist License
License Number: 46973 Primary Status: Current - Active
Address :
1104 E 17th St
SANTA ANA CA 92701-2602
