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Licensing details for: 6711

Name: PLAZA DENTAL GROUP, BRYAN WATANABE PROF. DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: PLAZA DENTAL GROUP, BRYAN WATANABLE PROFESSIONAL DENTAL CORPORATION

Address of Record

40484 MURRIETA HOT SPRINGS RD.
STE. 102
MURRIETA CA 92563
RIVERSIDE county
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Issuance Date

February 5, 2007

Expiration Date

December 31, 2017

Current Date / Time

June 6, 2025
1:55:10 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WATANABE, BRYAN KAZUMI

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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY

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