Dental Board of California
Licensing details for: 56615
Name: KASTENHOLZ, SHADI
License Type: Dentist
Primary Status: Current - Active
Address of Record
9484 BLACK MOUNTAIN RD#E
SAN DIEGO CA 92126
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BLACK MOUNTAIN FAMILY DENTISTRY, DENTAL OFFICE OF SHADI KASTENHOL
License/Registration Type: Fictitious Name Permit
License Number: 10274 Primary Status: Current - Active
Address :
9484 BLACK MOUNTAIN ROAD, STE. E
SAN DIEGO CA 92126
SAN DIEGO 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: BLACK MOUNTAIN FAMILY DENTISTRY, DENTAL OFFICE OF SHADI KASTENHOL
License/Registration Type: Fictitious Name Permit
License Number: 10274 Primary Status: Current - Active
Address :
9484 BLACK MOUNTAIN ROAD, STE. E
SAN DIEGO CA 92126
SAN DIEGO COUNTY
