Dental Board of California
Licensing details for: 5674
Name: GATEWAY DENTAL GROUP OF EASTVALE, RODGERS DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: GATEWAY DENTALGROUP OF EASTVALE, RODGERS DENTAL CORP.
Address of Record
12571 LIMONITE AVE, STE 230
MIRA LOMA CA 91752
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DIMITRI, RAMI GEORGE
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RODGERS, CHARLES FREDERICK
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: DIMITRI, RAMI GEORGE
License/Registration Type: Dentist License
License Number: 48596 Primary Status: Current - Active
Address :
8865 E Garden View Dr
ANAHEIM CA 92808-1678
ORANGE 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
