Dental Board of California
Licensing details for: 62689
Name: POLAN, MARYA
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Previous Names: VAYSBURG, MARYA
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: POLAN DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 11778 Primary Status: Cancelled
Address :
2660 5TH STREET
SUITE 30
ALAMEDA CA 94501
ALAMEDA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ALAMEDA LANDING DENTISTRY, DENTAL GROUP OF POLAN DENTAL CORPORATI
License/Registration Type: Fictitious Name Permit
License Number: 12149 Primary Status: Cancelled
Address :
2660 5th St
SUITE 30
ALAMEDA CA 94501-6577
ALAMEDA 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: ALAMEDA LANDING DENTISTRY, DENTAL GROUP OF POLAN DENTAL CORPORATI
License/Registration Type: Fictitious Name Permit
License Number: 12149 Primary Status: Cancelled
Address :
2660 5th St
SUITE 30
ALAMEDA CA 94501-6577
ALAMEDA COUNTY
