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Licensing details for: 13842

Name: GOLETA DENTAL PRACTICE MORTEZA MAZLOOM DDS

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

5370 HOLLISTER AVE STE A
SANTA BARBARA CA 93111
SANTA BARBARA county
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Practice Location

5370 HOLLISTER AVE STE A
SANTA BARBARA CA 93111
SANTA BARBARA county
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Issuance Date

October 27, 2017

Expiration Date

August 31, 2025

Current Date / Time

June 6, 2025
2:5:13 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MAZLOOM, MORTEZA

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: MAZLOOM, MORTEZA

License/Registration Type: Dentist License

License Number: 49596 Primary Status: Current - Active

Address :
5370 Hollister Ave
Suite A
SANTA BARBARA CA 93111-2303
SANTA BARBARA COUNTY

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