Dental Board of California
Licensing details for: 5949
Name: WINERY ESTATE DENTAL GROUP, GHAZAL AND HSIEH DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
7369 DAY CREEK BLVD
STE F-103
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HSIEH, JOHN TUNG
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GHAZAL, CAROLYN 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: HSIEH, JOHN TUNG
License/Registration Type: Dentist License
License Number: 49759 Primary Status: Current - Active
Address :
5090 JUNEAU COURT
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO 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: GHAZAL, CAROLYN G
License/Registration Type: Dentist License
License Number: 38682 Primary Status: Current - Active
Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
