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Licensing details for: 10572

Name: AZITA VAKILI, DMD, A DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: GATEWAY SMILES & IMPLANT CENTER

Address of Record

15725 POMERADO RD. #200
POWAY CA 92064
SAN DIEGO county
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Issuance Date

September 22, 2011

Expiration Date

March 31, 2027

Current Date / Time

June 6, 2025
2:20:40 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: VAKILI, AZITA

License/Registration Type: Dentist License

License Number: 36443 Primary Status: Current - Active

Address :
652 Stevens Ave
SOLANA BEACH CA 92075-2422
SAN DIEGO COUNTY

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