Dental Board of California
Licensing details for: 10358
Name: ESTHETIC SMILE DENTAL OFFICE, JACOB VAYNER, DMD, A PROFESSIONAL D
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: ESTHETIC SMILE DENTAL
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: VAYNER, JACOB J
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: VAYNER, JACOB J
License/Registration Type: Dentist License
License Number: 58805 Primary Status: Current - Active
Address :
19231 Victory Blvd
SUITE 455
RESEDA CA 91335-6308
LOS ANGELES COUNTY
