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Licensing details for: 79774

Name: KOHAN & RODEF DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

500 SAN FERNANDO MISSION BLVD, STE 2
SAN FERNANDO CA 91340
LOS ANGELES county
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Practice Location

500 SAN FERNANDO MISSION BLVD, STE 2
SAN FERNANDO CA 91340
LOS ANGELES county
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500 San Fernando Mission Blvd
Unit 110
SAN FERNANDO CA 91340-4061
LOS ANGELES county
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Issuance Date

August 21, 2018

Expiration Date

January 31, 2027

Current Date / Time

June 7, 2025
5:8:42 AM

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: RODEF, FARIBORZ

License/Registration Type: Dentist License

License Number: 38356 Primary Status: Current - Active

Address :
2233 E GARVEY AVE N
WEST COVINA CA 91791
LOS ANGELES COUNTY

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