Dental Board of California
Licensing details for: 17110
Name: KIRSHBAUM, GERALD M
License Type: Dentist
Primary Status: Current - Active
Address of Record
4698 Park Mirasol
CALABASAS CA 91302-1731
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PEDIATRIC DENTISTRY AND DENTAL I.V.
License/Registration Type: Fictitious Name Permit
License Number: 2814 Primary Status: Expired
Address :
5400 BALBOA BLVD #308
ENCINO CA 91316
LOS ANGELES 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: PEDIATRIC DENTISTRY AND DENTAL I.V.
License/Registration Type: Fictitious Name Permit
License Number: 2814 Primary Status: Expired
Address :
5400 BALBOA BLVD #308
ENCINO CA 91316
LOS ANGELES 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: KIRSHBAUM, GERALD M
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 396 Primary Status: Cancelled
Address :
5400 BALBOA BLVD STE 308
ENCINO CA 91316
LOS ANGELES COUNTY
