Dental Board of California
Licensing details for: 5052
Name: VISTA DENTAL GROUP, RODGERS AND DO DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
435 SOUTH MELROSE DR, STE B
VISTA CA 92084
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DO, DARREN TUAN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RODGERS, CHARLES FREDERICK
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RODGERS, CHARLES
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: DO, DARREN TUAN
License/Registration Type: Dentist License
License Number: 49303 Primary Status: Current - Active
Address :
3530 Linda Lee Ave
ROSEMEAD CA 91770-2013
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: 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
