Dental Board of California
Licensing details for: 13701
Name: SUPER SMILE ORTHODONTICS, DENTAL PRACTICE OF AHMAD KHAN DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KHAN, SHEHZAD AHMAD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: AHMAD, MUHAMMAD FAROOQ
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: AHMAD, MUHAMMAD FAROOQ
License/Registration Type: Dentist License
License Number: 45080 Primary Status: Current - Active
Address :
1245 E VISTA WAY
VISTA CA 92084
SAN DIEGO 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: KHAN, SHEHZAD AHMAD
License/Registration Type: Dentist License
License Number: 54611 Primary Status: Current - Active
Address :
18 Rancho Camino Dr
STE. 104
POMONA CA 91766-7003
LOS ANGELES COUNTY
