Dental Board of California
Licensing details for: 5160
Name: RIO VISTA FAMILY DENTISTRY, DENTAL OFFICE,
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Address of Record
8590 RIO SAN DIEGO DR, STE 110
SAN DIEGO CA 92108
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LOCKWOOD, JOY BONIFACIO
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BONIFACIO, JOY
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: REYES, RAQUEL REQUILMAN
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: LOCKWOOD, JOY BONIFACIO
License/Registration Type: Dentist License
License Number: 50126 Primary Status: Current - Active
Address :
7741 Eagle Ridge Dr
SAN DIEGO CA 92119-1769
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: REYES, RAQUEL REQUILMAN
License/Registration Type: Dentist License
License Number: 51516 Primary Status: Current - Active
Address :
8590 Rio San Diego Dr Ste 110
SAN DIEGO CA 92108-5597
SAN DIEGO COUNTY
