Dental Board of California
Licensing details for: 43447
Name: IBRAHIM, MAISY SAMI
License Type: Dentist
Primary Status: Current - Active
Address of Record
41990 COOK STREET
STE D402
PALM DESERT CA 92211
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GENTLE DENTAL INDIO, A DENTAL OFFICE OF IBRAHIM DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 4973 Primary Status: Cancelled
Address :
81557 DOCTOR CARREON BLVD
STE D-3
INDIO CA 92201
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: INDIO FAMILY DENTAL PRACTICE, A DENTAL OFFICE
License/Registration Type: Fictitious Name Permit
License Number: 3839 Primary Status: Cancelled
Address :
81557 DR CARREON BLVD, #D-3
INDIO CA 92201
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: INDIO FAMILY DENTAL PRACTICE, A DENTAL OFFICE
License/Registration Type: Fictitious Name Permit
License Number: 3839 Primary Status: Cancelled
Address :
81557 DR CARREON BLVD, #D-3
INDIO CA 92201
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: GENTLE DENTAL INDIO, A DENTAL OFFICE OF IBRAHIM DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 4973 Primary Status: Cancelled
Address :
81557 DOCTOR CARREON BLVD
STE D-3
INDIO CA 92201
RIVERSIDE COUNTY
