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Licensing details for: 15977

Name: NORTH PARK SMILES DENTAL OFFICE OF EDUARDO DIAZ DDS

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3638 EL CAJON BLVD., SUITE C
SAN DIEGO CA 92104
SAN DIEGO county
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Practice Location

3638 EL CAJON BLVD., SUITE C
SAN DIEGO CA 92104
SAN DIEGO county
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Issuance Date

September 11, 2020

Expiration Date

October 31, 2026

Current Date / Time

June 6, 2025
10:0:16 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: DIAZ, EDUARDO

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: DIAZ, EDUARDO

License/Registration Type: Dentist License

License Number: 44306 Primary Status: Current - Active

Address :
3638 Elcajon Blv
Siute A
SAN DIEGO CA 92104
SAN DIEGO COUNTY

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