Dental Board of California
Licensing details for: 5619
Name: BAKERSFIELD ORTHODONTIC DENTAL GROUP OF GUY W MENDIVIL,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
4050 SAN DIMAS ST
STE B
BAKERSFIELD CA 93301
KERN county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MENDIVIL, GUY WILLIAM
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: MENDIVIL, GUY WILLIAM
License/Registration Type: Dentist License
License Number: 29737 Primary Status: Current - Active
Address :
11901 Bolthouse Dr
SUITE 200
BAKERSFIELD CA 93311-8455
