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Licensing details for: 11819

Name: TIERRASANTA DENTAL GROUP, HABASHI DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

10405 TIERRASANTA BLVD
SAN DIEGO CA 92124
SAN DIEGO county
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Practice Location

10405 TIERRASANTA BLVD
SAN DIEGO CA 92124
SAN DIEGO county
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Issuance Date

January 21, 2015

Expiration Date

March 31, 2019

Current Date / Time

June 7, 2025
8:2:46 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: RYGG, LANCE CHRISTIAN

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: RYGG, LANCE CHRISTIAN

License/Registration Type: Dentist License

License Number: 30251 Primary Status: Cancelled

Address :
9862 E MISSION GORGE RD, STE E
SANTEE CA 92071
SAN DIEGO COUNTY

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