Dental Board of California
Licensing details for: 6633
Name: LA QUINTA DENTAL, A DENTAL OFFICE OF FRATT DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: LA QUINTA DENTAL
Address of Record
79255 HWY. 111
STE. 1
LA QUINTA CA 92253
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FRATT, DENNIS R
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: FRATT, DENNIS R
License/Registration Type: Dentist License
License Number: 24779 Primary Status: Expired
Address :
1005 BAYSIDE COVE
NEWPORT BEACH CA 92660
ORANGE COUNTY
