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Licensing details for: 1171

Name: MUNOZ, NUMA FERNANDO

License Type: Dentist General Anesthesia

Primary Status: Cancelled

Address of Record

7835 Lakeside Blvd Apt 946
BOCA RATON FL 33434-6265
PALM BEACH county
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Issuance Date

November 16, 1999

Expiration Date

August 31, 2015

Current Date / Time

June 7, 2025
2:48:53 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: DR LEE AND DR MUNOZ CHILDREN'S DENTAL

License/Registration Type: Fictitious Name Permit

License Number: 3569 Primary Status: Cancelled

Address :
1610 W EDINGER AVE, STE C
SANTA ANA CA 92704
ORANGE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CHILDREN'S DENTAL SURGERY CENTER, A DENTAL PRACTICE OF

License/Registration Type: Fictitious Name Permit

License Number: 4511 Primary Status: Cancelled

Address :
1610 WEST EDINGER AVE, STE C
SANTA ANA CA 92704
ORANGE COUNTY

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FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: CHILDRENS DENTAL CENTERS, DENTAL GROUP OF N. FERNANDO MUNOZ, DDS,

License/Registration Type: Fictitious Name Permit

License Number: 8298 Primary Status: Cancelled

Address :
14976 FOOTHILL BOULEVARD
STE. 100
FONTANA CA 92335
SAN BERNARDINO COUNTY

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GA to DDS or OMS or SP

License/Registration Role: General Anesthesia Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: MUNOZ, NUMA FERNANDO

License/Registration Type: Dentist License

License Number: 46894 Primary Status: Cancelled

Address :
7835 Lakeside Blvd Apt 946
BOCA RATON FL 33434-6265
PALM BEACH COUNTY

Map

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