Dental Board of California
Licensing details for: 12896
Name: MA FAMILY DENTISTRY DENTAL PRACTICE OF DIPAK KATBAMNA DDS P.C.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KATBAMNA, DIPAK
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: KATBAMNA, DIPAK
License/Registration Type: Dentist License
License Number: 57058 Primary Status: Current - Active
Address :
11916 Berlyn Dove Ct
JURUPA VALLEY CA 91752-2927
RIVERSIDE COUNTY
