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Licensing details for: 13640

Name: RANCHO CUCAMONGA SMILES DENTISTRY DENTAL GROUP, HSIEH AND ABDELKARIM DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

7319 MILLIKEN AVE STE 110
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Practice Location

7319 MILLIKEN AVE STE 110
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Issuance Date

July 20, 2017

Expiration Date

May 31, 2027

Current Date / Time

October 30, 2025
1:14:29 PM

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

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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: HSIEH, JOHN TUNG

License/Registration Type: Dentist License

License Number: 49759 Primary Status: Current - Active

Address :
5090 JUNEAU COURT
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO 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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE 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: WATANABE, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE 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: ABDELKARIM, MANAL KOUDSI

License/Registration Type: Dentist License

License Number: 54560 Primary Status: Current - Active

Address :
7319 Milliken Ave Ste 110
RANCHO CUCAMONGA CA 91730-6704
SAN BERNARDINO COUNTY

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