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Licensing details for: 8283

Name: GATEWAY DENTAL GROUP OF RIVERSIDE, WATANABE AND TO DENTAL CORPORA

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

10286 INDIANA AVENUE
RIVERSIDE CA 92503
RIVERSIDE county
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Practice Location

10286 INDIANA AVENUE
RIVERSIDE CA 92503
RIVERSIDE county
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Issuance Date

July 28, 2009

Expiration Date

December 31, 2013

Current Date / Time

June 6, 2025
2:10:57 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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