Dental Board of California
Licensing details for: 109121
Name: KEROLLES, SHADY NABIL SAAD
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by ADEX
License Relationships
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: Santa Fe Springs Modern Dentistry, Dental Group of Santa Fe Springs Modern Dentistry, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20187 Primary Status: Current - Active
Address :
13327 Florence Avenue
SANTA FE SPRINGS CA 90670
