Dental Board of California
Licensing details for: 80113
Name: SOROUSHIAN AND TAQAVI DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Expired
Organization Classification: Corporation
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: TAQAVI, POUYAN
License/Registration Type: Dentist License
License Number: 62710 Primary Status: Current - Active
Address :
1540 N Tracy Blvd
TRACY CA 95376-2903
STANISLAUS COUNTY
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: SOROUSHIAN, VASNA
License/Registration Type: Dentist License
License Number: 65124 Primary Status: Current - Active
Address :
3125 Coffee Rd # 7
MODESTO CA 95355-1768
STANISLAUS COUNTY
