Dental Board of California
Licensing details for: 885
Name: CREATIVE DIMENSIONS IN DENTISTRY DENTAL GROUP ERICKSON,DDS ET AL
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
15051 HESPERIAN BLVD
SAN LEANDRO CA 94578
ALAMEDA county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ERICKSON, MICHAEL J
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: VANDERSLOOT, RALPH PETER
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GRIGGS, REGINALD ARNOLD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SANTUCCI, EUGENE THOMAS
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MACKENZIE, GEORGE DAVID
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAASS, ROBERT MICHAEL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GUASTELLA, LUCILLE JOY
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: SANTUCCI, EUGENE THOMAS
License/Registration Type: Dentist License
License Number: 23141 Primary Status: Current - Active
Address :
245 LOWELL ST
REDWOOD CITY CA 94062
SAN MATEO COUNTY
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: GUASTELLA, LUCILLE JOY
License/Registration Type: Dentist License
License Number: 31620 Primary Status: Current - Active
Address :
40 DARTMOUTH PLACE
DANVILLE CA 94526
CONTRA COSTA COUNTY
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: MACKENZIE, GEORGE DAVID
License/Registration Type: Dentist License
License Number: 30605 Primary Status: Expired
Address :
3215 Gold Ct
LAFAYETTE CA 94549-5405
CONTRA COSTA COUNTY
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: GRIGGS, REGINALD ARNOLD
License/Registration Type: Dentist License
License Number: 31619 Primary Status: Current - Active
Address :
20265 Lake Chabot Rd
CASTRO VALLEY CA 94546
ALAMEDA COUNTY
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: ERICKSON, MICHAEL J
License/Registration Type: Dentist License
License Number: 19278 Primary Status: Cancelled
Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
ALAMEDA COUNTY
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: VANDERSLOOT, RALPH PETER
License/Registration Type: Dentist License
License Number: 22301 Primary Status: Expired
Address :
5700 STONERIDGE MALL RD
SUITE 290
PLEASANTON CA 94566
ALAMEDA COUNTY
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: MAASS, ROBERT MICHAEL
License/Registration Type: Dentist License
License Number: 25419 Primary Status: Expired
Address :
20265 LAKE CHABOT ROAD
CASTRO VALLEY CA 94546
ALAMEDA COUNTY
