Dental Board of California
Licensing details for: 3066
Name: BIMBLI, NIKOLIN SPIRO
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Adult
Address of Record
13901 S. HAWTHORNE BOULEVARD
HAWTHORNE CA 90250
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HAWTHORNE FAMILY & COSMETIC DENTAL OFFICE OF
License/Registration Type: Fictitious Name Permit
License Number: 4544 Primary Status: Cancelled
Address :
13402 S HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HAWTHORNE FAMILY AND COSMETIC DENTAL OFFICE, N. BIMBLI, DDS, A PR
License/Registration Type: Fictitious Name Permit
License Number: 10280 Primary Status: Current - Active
Address :
13901 S. HAWTHORNE BOULEVARD
HAWTHORNE CA 90250
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: BIMBLI, NIKOLIN SPIRO
License/Registration Type: Dentist License
License Number: 44147 Primary Status: Current - Active
Address :
13901 S HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY
