Dental Board of California
Licensing details for: 49605
Name: MORENO, IVAN ROEL
License Type: Dentist
Primary Status: Current - Active
Previous Names: MORENO, IBAN ROEL
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: GIA DENTAL GROUP, DENTAL GROUP OF IVAN R. MORENO, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 12774 Primary Status: Expired
Address :
355 K STREET, SUITE A
CHULA VISTA CA 91911
SAN DIEGO COUNTY
