Dental Board of California
Licensing details for: 17633
Name: NOHO MODERN DENTISTRY DENTAL GROUP, DOUGLAS DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
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: THOMAS, TREVOR JAMAL
License/Registration Type: Dentist License
License Number: 100514 Primary Status: Current - Active
Address :
11980 San Vicente Blvd
Ste. 507
LOS ANGELES CA 90049-5012
LOS ANGELES COUNTY
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: GALSTYAN, MARTIN ARAMIS
License/Registration Type: Dentist License
License Number: 61923 Primary Status: Current - Active
Address :
PO BOX 909
GLENDALE CA 91209
LOS ANGELES COUNTY
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: DOUGLAS, JORDAN CHELSEY
License/Registration Type: Dentist License
License Number: 105748 Primary Status: Current - Active
Address :
10306 Sepulveda Blvd
MISSION HILLS CA 91345-2422
LOS ANGELES COUNTY
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: ZAKLAMA, KARIM MAGID
License/Registration Type: Dentist License
License Number: 61349 Primary Status: Current - Active
Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES COUNTY
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: HUYNH, PHI CANH
License/Registration Type: Dentist License
License Number: 56413 Primary Status: Current - Active
Address :
11700 Heliotrope Ct
BAKERSFIELD CA 93311-8751
KERN COUNTY
