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Licensing details for: 80089

Name: MASTOUR & FARD DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

587 N. VENTU PK. RD STE #C
NEWBURY PARK CA 91320
VENTURA county
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Practice Location

587 N. VENTU PK. RD STE #C
NEWBURY PARK CA 91320
VENTURA county
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Issuance Date

June 5, 2019

Expiration Date

August 31, 2024

Current Date / Time

June 6, 2025
8:56:15 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: SABBAGH FARD, ARASH

License/Registration Type: Dentist License

License Number: 48007 Primary Status: Current - Active

Address :
5620 SAWTELLE BLVD
CULVER CITY CA 90230
LOS ANGELES 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: MASTOUR, PEDRAM ELI

License/Registration Type: Dentist License

License Number: 47525 Primary Status: Current - Active

Address :
5620 SAWTELLE BLVD
CULVER CITY CA 90230
LOS ANGELES COUNTY

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