Dental Board of California
Licensing details for: 13965
Name: CAPISTRANO DENTAL GROUP, DR. DIAA FAHMY
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Partnership
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FAHMY, DIAA SAMIR
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: FAHMY, DIAA SAMIR
License/Registration Type: Dentist License
License Number: 34091 Primary Status: Expired
Address :
12657 166th St
CERRITOS CA 90703-2101
LOS ANGELES COUNTY
