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Licensing details for: 5371

Name: BEAR CREEK DENTAL GROUP, WATANABE AND NGUYEN PROF.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

36068 HIDDEN SPRINGS RD, STE H
WILDOMAR CA 92595
RIVERSIDE county
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Issuance Date

January 26, 2005

Expiration Date

December 31, 2013

Current Date / Time

June 6, 2025
1:44:12 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, BACH XUAN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, BRYAN KAZUMI

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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
4443 Candlewood St
LAKEWOOD CA 90712-1736

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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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY

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