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Licensing details for: 10064

Name: SOLANA SMILES, DENTAL PRACTICE OF AZITA VAKILI, DMD, A DENTAL COR

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: SOLANA SMILES

Address of Record

530 LOMAS SANTA FE DRIVE #3
SOLANA BEACH CA 92075
SAN DIEGO county
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Practice Location

530 LOMAS SANTA FE DRIVE #3
SOLANA BEACH CA 92075
SAN DIEGO county
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Issuance Date

August 13, 2012

Expiration Date

March 31, 2021

Current Date / Time

June 6, 2025
1:58:35 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: VAKILI, AZITA

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: VAKILI, AZITA

License/Registration Type: Dentist License

License Number: 36443 Primary Status: Current - Active

Address :
652 Stevens Ave
SOLANA BEACH CA 92075-2422
SAN DIEGO COUNTY

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