Dental Board of California
Licensing details for: 14645
Name: SERRA MESA MODERN DENTISTRY DENTAL GROUP FEDOR DENTAL CORPORATION
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: REAGAN, DARIN SCOTT
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NOSTI, JOHN CHARLES
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ARIANNEJAD, BABAK
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FEDOR, GRACE CATHERINE
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: NOSTI, JOHN CHARLES
License/Registration Type: Dentist License
License Number: 48655 Primary Status: Current - Active
Address :
709 Center Dr Ste 101
SAN MARCOS CA 92069-2502
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: REAGAN, DARIN SCOTT
License/Registration Type: Dentist License
License Number: 34407 Primary Status: Current - Active
Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE 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: FEDOR, GRACE CATHERINE
License/Registration Type: Dentist License
License Number: 100550 Primary Status: Current - Active
Address :
3268 Greyling Dr
SAN DIEGO CA 92123-2230
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: ARIANNEJAD, BABAK
License/Registration Type: Dentist License
License Number: 59452 Primary Status: Current - Active
Address :
718 W Washington St
SAN DIEGO CA 92103-1938
SAN DIEGO COUNTY
