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Licensing details for: 1468

Name: PACIFIC DENTAL GROUP, DR. JOHN MAROON

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Address of Record

310 THIRD AVE, STE C-1B
CHULA VISTA CA 91910
SAN DIEGO county
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Issuance Date

October 30, 1996

Expiration Date

March 31, 2003

Current Date / Time

December 13, 2025
1:44:56 PM

License Relationships

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: HOSSEINI, BABAK

License/Registration Type: Dentist License

License Number: 42662 Primary Status: Current - Active

Address :
230 F ST STE D
CHULA VISTA CA 91910
SAN DIEGO COUNTY

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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: HOSSEINI-MAROON, MANIJEH

License/Registration Type: Dentist License

License Number: 40946 Primary Status: Current - Active

Address :
310 Third Ave Ste C1B
CHULA VISTA CA 91910-3954
SAN DIEGO COUNTY

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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: MAROON, JOHN PAUL

License/Registration Type: Dentist License

License Number: 40671 Primary Status: Current - Active

Address :
310 THIRD AVE
SUITE C-1B
CHULA VISTA CA 91910
SAN DIEGO COUNTY

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