Dental Board of California
Licensing details for: 100600
Name: ASSAD, MARTINA M
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MA DENTAL PRACTICE OF MARTINA ASSAD, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 17431 Primary Status: Current - Active
Address :
22430 VAN BUREN BLVD SUITE 200
MARCH AIR RESERVE BA CA 92518
RIVERSIDE 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: MA DENTAL PRACTICE OF MARTINA ASSAD, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 17431 Primary Status: Current - Active
Address :
22430 VAN BUREN BLVD SUITE 200
MARCH AIR RESERVE BA CA 92518
RIVERSIDE COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: ASSAD, MARTINA M
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 4112 Primary Status: Expired
Address :
22430 Van Buren Blvd
200
RIVERSIDE CA 92518-2709
RIVERSIDE COUNTY
