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Licensing details for: 61500

Name: ABOLFAZLIAN, ARASH

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

111 DEERWOOD RD #390
SAN RAMON CA 94583
CONTRA COSTA county
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Practice Location

111 Deerwood Rd
Suite 390
111 Deerwood Rd.
SAN RAMON CA 94583-4409
CONTRA COSTA county
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Issuance Date

July 16, 2012

Expiration Date

January 31, 2027

Current Date / Time

December 13, 2025
9:42:53 AM

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: CROW CANYON ORTHODONTICS, DENTAL PRACTICE OF ARASH ABOLFAZLIAN, D

License/Registration Type: Fictitious Name Permit

License Number: 11142 Primary Status: Current - Active

Address :
111 DEERWOOD ROAD SUITE 390
SAN RAMON CA 94583
CONTRA COSTA COUNTY

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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: WALNUT CREEK ORTHODONTICS DENTAL PRACTICE OF ABOLFAZLIAN DENTAL, INC.

License/Registration Type: Fictitious Name Permit

License Number: 16239 Primary Status: Cancelled

Address :
218 NORTH WIGET LN
WALNUT CREEK CA 94598
CONTRA COSTA COUNTY

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