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Licensing details for: 15155

Name: MIRA LOMA SMILES DENTISTRY DENTAL GROUP TON AND DHAMA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

6445 PAT'S RANCH ROAD, SUITE G
MIRA LOMA CA 91752
RIVERSIDE county
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Practice Location

6445 PAT'S RANCH ROAD, SUITE G
MIRA LOMA CA 91752
RIVERSIDE county
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Issuance Date

July 19, 2019

Expiration Date

April 30, 2027

Current Date / Time

June 6, 2025
2:12:46 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BRAR, JASLEEN KAUR

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: WATANABE, BRYAN KAZUMI

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DHAMA, DEEPIKA S

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: TON, CONG THAT

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

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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: DHAMA, DEEPIKA S

License/Registration Type: Dentist License

License Number: 49044 Primary Status: Current - Active

Address :
2044 California Ave
CORONA CA 92881-3300
RIVERSIDE 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: BRAR, JASLEEN KAUR

License/Registration Type: Dentist License

License Number: 43903 Primary Status: Current - Active

Address :
18102 Irvine Blvd Ste 205
TUSTIN CA 92780-3424
ORANGE 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: TON, CONG THAT

License/Registration Type: Dentist License

License Number: 58713 Primary Status: Current - Active

Address :
9631 RINDGE CIRCLE
FOUNTAIN VALLEY CA 92708
ORANGE 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: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY

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