Dental Board of California
Licensing details for: 11453
Name: SIERRA SMILES DENTISTRY AND ORTHODONTICS DENTAL GROUP, MARK J. BR
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: GHAZAL, CAROLYN G
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
