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Licensing details for: 9058

Name: TRIANGLE DENTAL GROUP AND ORTHODONTICS - MY KIDS DENTIST, COMPEAN

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: TRIANGLE DENTAL GROUP - MY KIDS DENTIST COMPEAN AND JEFFERSON DENTAL CORPORATION TRIANGLE DENTAL GROUP - MY KIDS DENTIST, GENERAL DENTAL GROUP OF COMPEAN AND JEFFERSON DENTAL CORPORATION

Address of Record

14305 BASELINE AVENUE
FONTANA CA 92336
SAN BERNARDINO county
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Practice Location

14305 BASELINE AVENUE
FONTANA CA 92336
SAN BERNARDINO county
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Issuance Date

November 18, 2010

Expiration Date

May 31, 2015

Current Date / Time

June 7, 2025
8:13:30 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: COMPEAN, CARLOS GUILLERMO

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: COMPEAN, CARLOS GUILLERMO

License/Registration Type: Dentist License

License Number: 29127 Primary Status: Current - Active

Address :
10945South St. Ste. 200A
CERRITOS CA 90703
LOS ANGELES COUNTY

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