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Licensing details for: 79932

Name: FEDOR DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3268 GREYLING DRIVE
SAN DIEGO CA 92123
SAN DIEGO county
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Practice Location

3268 GREYLING DRIVE
SAN DIEGO CA 92123
SAN DIEGO county
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Issuance Date

December 13, 2018

Expiration Date

August 31, 2026

Current Date / Time

June 6, 2025
2:29:9 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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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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: ARIANNEJAD, BABAK

License/Registration Type: Dentist License

License Number: 59452 Primary Status: Current - Active

Address :
718 W Washington St
SAN DIEGO CA 92103-1938
SAN DIEGO COUNTY

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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: NOSTI, JOHN CHARLES

License/Registration Type: Dentist License

License Number: 48655 Primary Status: Current - Active

Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
SAN DIEGO COUNTY

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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: FEDOR, GRACE CATHERINE

License/Registration Type: Dentist License

License Number: 100550 Primary Status: Current - Active

Address :
3268 Greyling Dr
SAN DIEGO CA 92123-2230
SAN DIEGO COUNTY

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