Dental Board of California
Licensing details for: 5311
Name: SOUTH BAY CHULA VISTA FAMILY DENTAL OFFICE OF
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
290 LANDIS, STE A & B
CHULA VISTA CA 91910
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GALLO, DONALD ALFRED
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MICHELS, ALAN G
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: MICHELS, ALAN G
License/Registration Type: Dentist License
License Number: 19777 Primary Status: Current - Active
Address :
3529 Castleman Ln
BURBANK CA 91504-1663
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: GALLO, DONALD ALFRED
License/Registration Type: Dentist License
License Number: 31040 Primary Status: Expired
Address :
328 Harbour Sound Ct
BRADENTON FL 34209-3261
MIAMI-DADE COUNTY
