Dental Board of California
Licensing details for: 4801
Name: CENTER FOR ORAL & FACIAL SURGERY, DENTAL GROUP OF
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Partnership
Previous Names: CENTER FOR ORAL % FACIAL SURGERY, DENTAL GROUP OF
Address of Record
306 WALNUT AVE, STE 26
SAN DIEGO CA 92103
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PAVEL, FRANK LESTER
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ECKSTEIN, JAMES RICHARD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CALDEMEYER, CORTLAND S
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HENDRIX, WILLIAM E
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: ECKSTEIN, JAMES RICHARD
License/Registration Type: Dentist License
License Number: 38273 Primary Status: Current - Active
Address :
306 WALNUT AVENUE
SUITE 26
SAN DIEGO CA 92103
SAN DIEGO 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: HENDRIX, WILLIAM E
License/Registration Type: Dentist License
License Number: 18335 Primary Status: Deceased
Address :
14169 HILLSIDE DRIVE
JAMUL CA 91935
SAN DIEGO 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: CALDEMEYER, CORTLAND S
License/Registration Type: Dentist License
License Number: 47693 Primary Status: Cancelled
Address :
920 S WILLOW AVE
COOKEVILLE TN 38501
PUTNAM 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: PAVEL, FRANK LESTER
License/Registration Type: Dentist License
License Number: 29414 Primary Status: Expired
Address :
2405 MARILOUISE WAY
SAN DIEGO CA 92103
SAN DIEGO COUNTY
