Dental Board of California
Licensing details for: 1419
Name: BALASANIAN, EDWARD
License Type: Dentist General Anesthesia
Primary Status: Current - Active
Previous Names: BALASANIAN, EDUARD
Address of Record
1171 Puerta Del Sol
Suite D
SAN CLEMENTE CA 92673-6343
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.
License/Registration Type: Fictitious Name Permit
License Number: 13021 Primary Status: Expired
Address :
1171 PUERTA DEL SOL, #D
SAN CLEMENTE CA 92673
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.
License/Registration Type: Fictitious Name Permit
License Number: 13020 Primary Status: Expired
Address :
360 SAN MIGUEL, #402
NEWPORT BEACH CA 92660
ORANGE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ORANGE COUNTY CENTERS FOR ORAL SURGERY AND DENTAL IMPLANTS CUMMINGS, BALASANIAN, CAPUTO & NICHOLLS DENTAL GROUP INC.
License/Registration Type: Fictitious Name Permit
License Number: 12962 Primary Status: Expired
Address :
26302 LA PAZ ROAD, #102
MISSION VIEJO CA 92691
ORANGE COUNTY
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: BALASANIAN, EDWARD
License/Registration Type: Dentist License
License Number: 48702 Primary Status: Current - Active
Address :
1171 Puerta Del Sol
Suite D
SAN CLEMENTE CA 92673-6343
ORANGE COUNTY
