Dental Board of California
Licensing details for: 11816
Name: KINGS FAMILY DENTAL GROUP, FOR SIMON MASOOD IMANUEL, D.M.D., INC.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
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: IMANUEL, SIMON MASOOD
License/Registration Type: Dentist License
License Number: 39418 Primary Status: Current - Active
Address :
14114 Polk Street
SYLMAR CA 91342
LOS ANGELES COUNTY
