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Licensing details for: 12369

Name: SAN DIEGO DENTAL ARTS DENTAL OFFICE OF DR. MAROON

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2168 BALBOA AVENUE, SUITE 1
PACIFIC BEACH CA 92109
SAN DIEGO county
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Issuance Date

September 8, 2015

Expiration Date

March 31, 2021

Current Date / Time

December 13, 2025
9:41:28 AM

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: HOSSEINI-MAROON, MANIJEH

License/Registration Type: Dentist License

License Number: 40946 Primary Status: Current - Active

Address :
310 Third Ave Ste C1B
CHULA VISTA CA 91910-3954
SAN DIEGO COUNTY

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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: MAROON, JOHN PAUL

License/Registration Type: Dentist License

License Number: 40671 Primary Status: Current - Active

Address :
310 THIRD AVE
SUITE C-1B
CHULA VISTA CA 91910
SAN DIEGO COUNTY

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