Dental Board of California
Licensing details for: 12263
Name: MARKET WEST DENTAL GROUP, PATEL AND GHAZAL DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Secondary Status: Cancelled at the Request of the Licensee
Previous Names: MARKET WEST DENTAL GROUP AND ORTHODONTICS, PATEL AND GHAZAL DENTA ❖ MARKET WEST DENTAL GROUP
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GHAZAL, CAROLYN G
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PATEL, PRIYA V
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
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: PATEL, PRIYA V
License/Registration Type: Dentist License
License Number: 55194 Primary Status: Current - Active
Address :
11676 Treadwell Dr
POWAY CA 92064-6134
SAN DIEGO COUNTY
