Dental Board of California
Licensing details for: 16815
Name: HACIENDA FAMILY DENTAL PRACTICE OF ELGENDI DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ELGENDI, HAITHAM HAMZA
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: ELGENDI, HAITHAM HAMZA
License/Registration Type: Dentist License
License Number: 46787 Primary Status: Current - Active
Address Not Disclosed
