Dental Board of California
Licensing details for: 8730
Name: SAN DIEGO DENTAL GROUP OF VALLEY PARKWAY, C. S. NICHOLSON,III, DD
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: SAN DIEGO DENTAL CARE GROUP OF VALLEY PARKWAY, C.S. NICHOLSON IIII DDS INC.
Address of Record
913 E. VALLEY PARKWAY
ESCONDIDO CA 92025
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NICHOLSON, CHARLES SIMMS III
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: NICHOLSON, CHARLES SIMMS III
License/Registration Type: Dentist License
License Number: 20425 Primary Status: Expired
Address :
236 Jamacha Rd
101
EL CAJON CA 92019-2366
SAN DIEGO COUNTY
