License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 732 Primary Status: Cancelled
Address :
SCOTT JACKS DDS INC
4444 TWEEDY BLVD
SOUTH GATE CA 90292
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: CHILDREN'S DENTAL GROUP
License/Registration Type: Fictitious Name Permit
License Number: 732 Primary Status: Cancelled
Address :
SCOTT JACKS DDS INC
4444 TWEEDY BLVD
SOUTH GATE CA 90292
LOS ANGELES COUNTY
