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Licensing details for: 10041

Name: ROSEVILLE TOPSMILES DENTAL PRACTICE OF OKHOVAT PROFESSIONAL DENTA

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2110 PROFESSIONAL DRIVE, STE. 115
ROSEVILLE CA 95661
PLACER county
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Practice Location

2110 PROFESSIONAL DRIVE, STE. 115
ROSEVILLE CA 95661
PLACER county
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Issuance Date

July 18, 2012

Expiration Date

June 30, 2024

Current Date / Time

June 7, 2025
3:12:32 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: OKHOVAT, SIAMAK

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: OKHOVAT, SIAMAK

License/Registration Type: Dentist License

License Number: 47541 Primary Status: Current - Active

Address :
2231 Douglas Blvd
STE 110
ROSEVILLE CA 95661-4264
PLACER COUNTY

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