Dental Board of California
Licensing details for: 12276
Name: POMONA DENTISTRY DENTAL GROUP AWAD AND MOORE DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
2071 RANCHO VALLEY DRIVE,
SUITE 140
POMONA CA 91766
LOS ANGELES 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: 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: MOORE, ANDREA CHRISTIANE
License/Registration Type: Dentist License
License Number: 48337 Primary Status: Expired
Address :
1875 N Campus Ave
UPLAND CA 91784-8208
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: WATANABE, BRYAN KAZUMI
License/Registration Type: Dentist License
License Number: 40130 Primary Status: Current - Active
Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE 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: AWAD, PAUL YOUSSEF
License/Registration Type: Dentist License
License Number: 60197 Primary Status: Current - Active
Address :
2071 RANCHO VALLEY DR. STE 140
POMONA CA 91766
LOS ANGELES COUNTY
