Dental Board of California
Licensing details for: 14191
Name: CALIFORNIA IMPLANT SMILES, DENTAL GROUP OF ALEX GLADKOV A PROFESSIONAL DENTAL CORPORATION
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: GLADKOV, ALEXANDRE GREGORY
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: GLADKOV, ALEXANDRE GREGORY
License/Registration Type: Dentist License
License Number: 40822 Primary Status: Current - Active
Address :
1920 E 17th St
Suite 100
SANTA ANA CA 92705
ORANGE COUNTY
