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Licensing details for: 6417

Name: PACIFIC VIEW DENTAL GROUP, PERIKLIS T. PROUSSAEFS, DDS, MS, A PRO

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: PACIFIC VIEW DENTAL GROUP

Address of Record

3585 TELEGRAPH ROAD, STE. C
VENTURA CA 93003
VENTURA county
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Issuance Date

August 25, 2006

Expiration Date

March 31, 2026

Current Date / Time

June 6, 2025
9:21:36 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PROUSSAEFS, PERIKLIS THEODORE

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: PROUSSAEFS, PERIKLIS THEODORE

License/Registration Type: Dentist License

License Number: 45310 Primary Status: Current - Active

Address :
3585 TELEGRAPH ROAD
SUITE C
VENTURA CA 93003
VENTURA COUNTY

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