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Licensing details for: 17467

Name: TALMADGE FAMILY DENTAL DENTAL PRACTICE OF ALEXANDROS REIZIAN

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: TALMODGE FAMILY DENTAL DRS. REIZIAN AND MORENO

Address of Record

4711 MONROE AVE
SAN DIEGO CA 92115
SAN DIEGO county
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Practice Location

4711 MONROE AVE
SAN DIEGO CA 92115
SAN DIEGO county
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Issuance Date

November 1, 2022

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
10:6:1 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REIZIAN, ALEXANDROS MIHALIS

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: REIZIAN, ALEXANDROS MIHALIS

License/Registration Type: Dentist License

License Number: 64496 Primary Status: Current - Active

Address :
4711 MONROE AVE
SAN DIEGO CA 92115-3202
SAN DIEGO COUNTY

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