Dental Board of California
Licensing details for: 6788
Name: GENESIS DENTAL GROUP, ROBERT T. CADALSO, JR., PROF. DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: GENESIS DENTAL GROUP
Address of Record
24896 CHRISANTA DRIVE
STE. 110
MISSION VIEJO CA 92691
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CADALSO, ROBERT TOMAS JR
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: CADALSO, ROBERT TOMAS JR
License/Registration Type: Dentist License
License Number: 30639 Primary Status: Deceased
Address :
2855 Chateau Way
LAGUNA BEACH CA 92651-2010
ORANGE COUNTY
