Dental Board of California
Licensing details for: 4650
Name: BAKERSFIELD DENTAL GROUP, GHAZAL, RODGERS, REAGAN
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
5120 STOCKDALE HWY,
SUITES D & E
BAKERSFIELD CA 93309
KERN county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: REAGAN, DARIN SCOTT
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RODGERS, CHARLES FREDERICK
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: RODGERS, CHARLES FREDERICK
License/Registration Type: Dentist License
License Number: 35324 Primary Status: Current - Active
Address :
131 W Ontario Ave
Suite 103
CORONA CA 92882-5274
RIVERSIDE 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: REAGAN, DARIN SCOTT
License/Registration Type: Dentist License
License Number: 34407 Primary Status: Current - Active
Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY
