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Licensing details for: 17960

Name: BLOSSOM DENTAL CARE DENTAL PRACTICE OF DR. PARSA INC.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

25 NORTH 14TH STREET, SUITE 820
SAN JOSE CA 95112
SANTA CLARA county
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Practice Location

25 NORTH 14TH STREET, SUITE 820
SAN JOSE CA 95112
SANTA CLARA county
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Issuance Date

July 12, 2023

Expiration Date

May 31, 2024

Current Date / Time

June 6, 2025
9:57:52 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PARSA, PARASTOO

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: PARSA, PARASTOO

License/Registration Type: Dentist License

License Number: 49632 Primary Status: Current - Active

Address :
25 N 14th St Ste 820
SAN JOSE CA 95112-6215
SANTA CLARA COUNTY

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