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Licensing details for: 10710

Name: IMPERIAL SMILES FAMILY DENTAL, OFFICE OF NATALIE DERBOGHOSSIANS D

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: IMPERIAL SMILES FAMILY DENTAL, DENTAL OFFICE OF DR. NATALIE DERBOGHOSSIAN

Address of Record

11017 ATLANTIC AVENUE 2ND FLOOR
LYNWOOD CA 90262
LOS ANGELES county
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Practice Location

11017 ATLANTIC AVENUE 2ND FLOOR
LYNWOOD CA 90262
LOS ANGELES county
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Issuance Date

September 13, 2013

Expiration Date

November 30, 2014

Current Date / Time

June 6, 2025
2:6:27 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DERBOGHOSSIANS, NATALIE

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: DERBOGHOSSIANS, NATALIE

License/Registration Type: Dentist License

License Number: 55001 Primary Status: Current - Active

Address :
2321 Panorama Dr
LA CRESCENTA CA 91214
LOS ANGELES COUNTY

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