Dental Board of California
Licensing details for: 100550
Name: FEDOR, GRACE CATHERINE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by Residency
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: FEDOR DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79932 Primary Status: Current - Active
Address :
3268 GREYLING DRIVE
SAN DIEGO CA 92123
SAN DIEGO COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: SERRA MESA MODERN DENTISTRY DENTAL GROUP FEDOR DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14645 Primary Status: Current - Active
Address :
3268 GREYLING DRIVE
SAN DIEGO CA 92123
SAN DIEGO COUNTY
