Dental Board of California
Licensing details for: 4522
Name: VINELAND FAMILY DENTAL GROUP, ESCUTIN & ESTACIO,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
8052 VINELAND AVE, STE 109
SUN VALLEY CA 91352
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ESCUTIN, PETER O
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ESTACIO, DANIEL T
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ESTACIO, DANIEL TORIBIO
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ESCUTIN, PETER ONG
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: ESTACIO, DANIEL TORIBIO
License/Registration Type: Dentist License
License Number: 47886 Primary Status: Current - Active
Address :
27310 ROSE MALLOW LN
SANTA CLARITA CA 91387
LOS ANGELES 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: ESCUTIN, PETER ONG
License/Registration Type: Dentist License
License Number: 38992 Primary Status: Current - Active
Address :
23119 Soboba Rd
SAN JACINTO CA 92583-2903
RIVERSIDE COUNTY
