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Licensing details for: 4236

Name: DENTAL PRACTICE OF SAN BERNARDINO,

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Partnership

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

322 NORTH H STREET
SAN BERNARDINO CA 92410
SAN BERNARDINO county
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Issuance Date

April 29, 2003

Expiration Date

July 31, 2020

Current Date / Time

November 3, 2025
6:59:51 PM

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: PATEL, HEMANTKUMAR

License/Registration Type: Dentist License

License Number: 29647 Primary Status: Current - Active

Address :
615 N Benson Ave Ste F
UPLAND CA 91786-5076
SAN BERNARDINO 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: PATEL, VIJAYKUMAR BHANUBHAI

License/Registration Type: Dentist License

License Number: 36595 Primary Status: Current - Active

Address :
601 E Foothill Blvd
CLAREMONT CA 91711-3512
LOS ANGELES COUNTY

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