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Licensing details for: 7387

Name: BAKERSFIELD ORTHODONTIC DENTAL GROUP, GUY W. MENDIVIL, DDS, PROF.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

515 W. COLUMBUS ST.
STE. A
BAKERSFIELD CA 93301
KERN county
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Practice Location

11901 BOLTHOUSE DR STE 200
BAKERSFIELD CA 93311-8456
KERN county
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Issuance Date

March 10, 2008

Expiration Date

November 30, 2022

Current Date / Time

June 7, 2025
8:29:26 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MENDIVIL, GUY WILLIAM

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: MENDIVIL, GUY WILLIAM

License/Registration Type: Dentist License

License Number: 29737 Primary Status: Current - Active

Address :
11901 Bolthouse Dr
SUITE 200
BAKERSFIELD CA 93311-8455

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