Dental Board of California
Licensing details for: 15031
Name: ENERGETIC SMILE FAMILY DENTAL, DENTAL PRACTICE OF DR. LENA DEBAZ
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SACA, LENA DEBAZ
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: SACA, LENA DEBAZ
License/Registration Type: Dentist License
License Number: 100403 Primary Status: Current - Active
Address :
307 N BREA BLVD
BREA CA 92821
ORANGE COUNTY
