Dental Board of California
Licensing details for: 8818
Name: TERRACE DENTAL GROUP - MY KIDS DENTIST, RODGERS AND DO PROF. DENT
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: TERRACE DENTAL GROUP - MY KIDS DENTIST
Address of Record
320 SYCAMORE AVE.
STE. 60
VISTA CA 92083
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RODGERS, CHARLES FREDERICK
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: RODGERS, CHARLES FREDERICK
License/Registration Type: Dentist License
License Number: 35324 Primary Status: Current - Active
Address :
131 W Ontario Ave
Suite 103
CORONA CA 92882-5274
RIVERSIDE COUNTY
