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Licensing details for: 16462

Name: AVAH DENTAL OFFICE MARLENE M. THOMPSON D.D.S, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1001 W SAN MARCOS BLVD #106C
SAN MARCOS CA 92078
SAN DIEGO county
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Practice Location

1001 W SAN MARCOS BLVD #106C
SAN MARCOS CA 92078
SAN DIEGO county
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Issuance Date

April 20, 2021

Expiration Date

December 31, 2025

Current Date / Time

June 6, 2025
10:7:2 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: THOMPSON, MARLENE MAVILLA

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: THOMPSON, MARLENE MAVILLA

License/Registration Type: Dentist License

License Number: 50382 Primary Status: Current - Active

Address :
1001 W San Marcos Blvd
106C
SAN MARCOS CA 92078-4012
SAN DIEGO COUNTY

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