Dental Board of California
Licensing details for: 11431
Name: MEDICAL CENTER DENTAL GROUP, WADID FATTOUCH, D.D.S., INC.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Secondary Status: Cancelled at the Request of the Licensee
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FATTOUCH, WADID ANTOINE
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: FATTOUCH, WADID ANTOINE
License/Registration Type: Dentist License
License Number: 30544 Primary Status: Expired
Address :
1900 Pacific Coast Hwy Apt 18
18
18
HUNTINGTON BEACH CA 92648-3952
ORANGE COUNTY
