Dental Board of California
Licensing details for: 52484
Name: YAMAZAKI, KIYOMI
License Type: Dentist
Primary Status: Current - Active
Address of Record
1143 W Gardena Blvd
GARDENA CA 90247-4823
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GARDENA FAMILY DENTAL PRACTICE OF KIYOMI YAMAZAKI, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 8448 Primary Status: Current - Active
Address :
1143 W GARDENA BOULEVARD
GARDENA CA 90247
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: GARDENA FAMILY DENTAL PRACTICE OF KIYOMI YAMAZAKI, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 8448 Primary Status: Current - Active
Address :
1143 W GARDENA BOULEVARD
GARDENA CA 90247
LOS ANGELES COUNTY
