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Licensing details for: 14854

Name: APEX IMPLANT CENTER & DENTISTRY DENTAL OFFICE OF UPPAL DENTAL GROUP, INC.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

360 S GLENDORA AVE, UNIT 1
WEST COVINA CA 91790
LOS ANGELES county
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Practice Location

360 S GLENDORA AVE, UNIT 1
WEST COVINA CA 91790
LOS ANGELES county
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Issuance Date

February 25, 2019

Expiration Date

December 31, 2021

Current Date / Time

June 21, 2025
9:34:9 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: UPPAL, GAGAN

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: UPPAL, GAGAN

License/Registration Type: Dentist License

License Number: 55640 Primary Status: Current - Active

Address :
360 S. Glendora Ave #1
WEST COVINA CA 91790
LOS ANGELES COUNTY

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