Dental Board of California
Licensing details for: 13969
Name: EVERSHINE DENTAL GROUP, CAROLYN CASTANEDA FASSIOLI, DDS
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CASTANEDA FASSIOLI, CAROLYN ELIZABETH
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: CASTANEDA FASSIOLI, CAROLYN ELIZABETH
License/Registration Type: Dentist License
License Number: 101094 Primary Status: Current - Active
Address :
22706 Aspan St
Suite 602
LAKE FOREST CA 92630-1603
ORANGE COUNTY
