Dental Board of California
Licensing details for: 12423
Name: SMILE WIDE DENTAL GROUP, BADII LEE DENTAL CORPORATION, INC.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: SMILE WIDE, BADII LEE DENTAL CORPORATION, INC.
Address of Record
22330 HAWTHORNE BLVD, #216
TORRANCE CA 90505
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BADII, KIAVASH KEVIN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LEE, DANIEL HARVEY
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: LEE, DANIEL HARVEY
License/Registration Type: Dentist License
License Number: 56861 Primary Status: Current - Active
Address :
14252 Culver Dr
Suite 831
IRVINE CA 92604-0317
ORANGE 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: BADII, KIAVASH KEVIN
License/Registration Type: Dentist License
License Number: 54538 Primary Status: Current - Active
Address :
1424 S Euclid St
FULLERTON CA 92832-3152
ORANGE COUNTY
