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Licensing details for: 81139

Name: H. REZA, A DENTAL CORPORATION.

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: H. REZA A DENTAL CORPORATION. H. REZA A DENTAL CORPORATION

Address of Record

12509 OXNARD ST. STE #201
NORTH HOLLYWOOD CA 91606
LOS ANGELES county
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Practice Location

12509 OXNARD ST. STE #201
NORTH HOLLYWOOD CA 91606
LOS ANGELES county
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Issuance Date

February 18, 2022

Expiration Date

September 30, 2022

Current Date / Time

June 21, 2025
9:46:52 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: REZA, HAMID

License/Registration Type: Dentist License

License Number: 41307 Primary Status: Current - Active

Address :
8540 RESEDA BLVD, #101
NORTHRIDGE CA 91324
LOS ANGELES COUNTY

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