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Licensing details for: 6293

Name: PACIFIC DENTAL GROUP, LYNDA WATANABE AND MAU NGUYEN DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

31754 U.S. HIGHWAY 79 SOUTH
TEMECULA CA 92592
RIVERSIDE county
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Issuance Date

July 7, 2006

Expiration Date

June 30, 2010

Current Date / Time

June 6, 2025
2:11:24 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, MAU KHAC-MINH

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, LYNDA CAROL

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, MAU KHAC-MINH

License/Registration Type: Dentist License

License Number: 48523 Primary Status: Current - Active

Address :
27180 Newport Rd
Ste. 2
MENIFEE CA 92584
RIVERSIDE COUNTY

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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, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE COUNTY

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