Dental Board of California
Licensing details for: 45429
Name: BASHAWATY, WALLY
License Type: Dentist
Primary Status: Current - Active
Previous Names: BACHAWATY, WALID I
Address of Record
1501 Superior Ave
Suite 306
NEWPORT BEACH CA 92663-3600
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BRIGHTON DENTAL CLINIQUE, DRS RAVON AND BASHAWATY DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 13808 Primary Status: Expired
Address :
9675 BRIGHTON WAY PENTHOUSE A
BEVERLY HILLS CA 90210
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: BRIGHTON DENTAL CLINIQUE, DRS RAVON AND BASHAWATY DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 13808 Primary Status: Expired
Address :
9675 BRIGHTON WAY PENTHOUSE A
BEVERLY HILLS CA 90210
LOS ANGELES COUNTY
