Dental Board of California
Licensing details for: 2635
Name: FAELDAN-SUAREZ, MARISSA VALMONTE
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Previous Names: FAELDAN, MARISSA VALMONTE ❖ FAELDAN-SUAREZ, MARISSA
Address of Record
5432 Sepulveda Blvd
B
B
CULVER CITY CA 90230-5512
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COCO LANE ORTHODONTICS DENTAL GROUP OF MARISSA FAELDAN-SUAREZ, DDS
License/Registration Type: Fictitious Name Permit
License Number: 18840 Primary Status: Current - Active
Address :
5432 SEPULVEDA BLVD. SUITE B
CULVER CITY CA 90230
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SMILE STREET PEDIATRIC DENTISTRY, DENTAL GROUP OF MARISSA FAELDAN
License/Registration Type: Fictitious Name Permit
License Number: 10573 Primary Status: Current - Active
Address :
5432 SEPULVEDA BOULEVARD, STE. B
CULVER CITY CA 90230
LOS ANGELES COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: FAELDAN-SUAREZ, MARISSA VALMONTE
License/Registration Type: Dentist License
License Number: 58944 Primary Status: Current - Active
Address :
5432 Sepulveda Blvd
B
B
CULVER CITY CA 90230-5512
LOS ANGELES COUNTY
