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Licensing details for: 10488

Name: SMILING SEA PEDIATRIC DENTISTRY, DENTAL OFFICE OF MICHELLE P TO D

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

32144 AGOURA ROAD #126
WESTLAKE VILLAGE CA 91361
VENTURA county
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Practice Location

32144 AGOURA ROAD #126
WESTLAKE VILLAGE CA 91361
VENTURA county
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Issuance Date

May 15, 2013

Expiration Date

December 31, 2022

Current Date / Time

June 7, 2025
5:11:54 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: TO, MICHELLE P

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: TO, MICHELLE P

License/Registration Type: Dentist License

License Number: 46337 Primary Status: Current - Active

Address :
12128 Vanowen St
NORTH HOLLYWOOD CA 91605-5651
LOS ANGELES COUNTY

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