Dental Board of California
Licensing details for: 12085
Name: DR. SHRIVER'S LA JOLLA SMILE CENTER DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Previous Names: DR. SHRIVER'S LA JOLLA SMILE CENTER
Address of Record
7817 IVANHOE AVENUE, SUITE 304
LA JOLLA CA 92037
SAN DIEGO county
Map
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: SHRIVER, NENI DIAH
License/Registration Type: Dentist License
License Number: 45194 Primary Status: Current - Active
Address :
7817 Ivanhoe Ave. Ste.304
LA JOLLA CA 92037
SAN DIEGO COUNTY
