Dental Board of California
Licensing details for: 15714
Name: WALNUT FAMILY DENTAL, A DENTAL OFFICE OF SAHAWNEH DENTAL CORPORATION
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: SAHAWNEH, SHOROUQ SAMEER
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: SAHAWNEH, SHOROUQ SAMEER
License/Registration Type: Dentist License
License Number: 55643 Primary Status: Current - Active
Address :
2300 Harbor Blvd.
Suite H5
COSTA MESA CA 92626
ORANGE COUNTY
