Dental Board of California
Licensing details for: 4558
Name: CORONA DENTAL CENTER, A DENTAL OFFICE OF SOE PROFESSIONAL
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
1074 W SIXTH ST
CORONA CA 92882
RIVERSIDE 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
