Dental Board of California
Licensing details for: 8904
Name: NEWPORT DENTAL CENTER GROUP, DENTAL OFFICE OF PALMER DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: NEWPORT DENTAL CENTER GROUP
Address of Record
2105 SAN JOAQUIN HILLS RD.
NEWPORT BEACH CA 92660
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PALMER, PAUL BRIAN
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: PALMER, PAUL BRIAN
License/Registration Type: Dentist License
License Number: 28603 Primary Status: Current - Inactive
Address :
23569 Sunnymead Ranch Pkwy
ste A
MORENO VALLEY CA 92557-2884
RIVERSIDE COUNTY
