Dental Board of California
Licensing details for: 10731
Name: TRACY SMILES MODERN DENTISTRY, DENTAL GROUP OF ENTABI DENTAL CORP
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: TRACY SMILES MEDERN DENTISTRY, DENTAL GROUP OF ENTABI DENTAL CORPORATION
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GHAZAL, CAROLYN G
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: STROMBERG, LOUIS ZANE
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LAMBRIDIS, DEAN
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: GHAZAL, CAROLYN G
License/Registration Type: Dentist License
License Number: 38682 Primary Status: Current - Active
Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
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: LAMBRIDIS, DEAN
License/Registration Type: Dentist License
License Number: 51199 Primary Status: Current - Active
Address :
30831 MARSEILLE WAY
WESTLAKE VILLAGE CA 91362
VENTURA COUNTY
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: ENTABI, KHALED
License/Registration Type: Dentist License
License Number: 56401 Primary Status: Current - Active
Address :
2600 S TRACY BL
STE 170
TRACY CA 95376
SAN JOAQUIN COUNTY
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: STROMBERG, LOUIS ZANE
License/Registration Type: Dentist License
License Number: 30879 Primary Status: Expired
Address :
16868 MAIN STREET
HESPERIA CA 92345
SAN BERNARDINO COUNTY
