Dental Board of California
Licensing details for: 14778
Name: BEACH HOUSE PEDIATRIC DENTISTRY DENTAL PRACTICE OF AMIT A. SHAH D.D.S., INC.
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: SHAH, AMIT ASHOK
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: SHAH, AMIT ASHOK
License/Registration Type: Dentist License
License Number: 58240 Primary Status: Current - Active
Address :
18377 Beach Blvd Ste 216
HUNTINGTON BEACH CA 92648-1349
ORANGE COUNTY
