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Licensing details for: 16008

Name: KIDZ DENTAL ANESTHESIA DENTAL GROUP OF DAVID TOMA DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1110 N. BRAND BLVD., SUITE 201
GLENDALE CA 91202
LOS ANGELES county
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Practice Location

1110 N. BRAND BLVD., SUITE 201
GLENDALE CA 91202
LOS ANGELES county
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Issuance Date

September 21, 2020

Expiration Date

March 31, 2021

Current Date / Time

December 14, 2025
3:52:43 PM

License Relationships

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: TOMA, DAVID SAMIR

License/Registration Type: Dentist License

License Number: 48042 Primary Status: Current - Active

Address :
1814 N Dinuba Blvd
VISALIA CA 93291-3014

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