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Licensing details for: 17972

Name: CHILDREN'S DENTAL FUNZONE DENTAL OFFICE OF RODEF, YAGHOUBI, ROBLES DENTAL OFFICE OF COLTON, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1280 E. WASHINGTON STREET, SUITE B10,
COLTON CA 92324
SAN BERNARDINO county
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Practice Location

1280 E. WASHINGTON STREET, SUITE B10,
COLTON CA 92324
SAN BERNARDINO county
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Issuance Date

July 20, 2023

Expiration Date

January 31, 2027

Current Date / Time

December 13, 2025
5:24:13 PM

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: RODEF, FARIBORZ

License/Registration Type: Dentist License

License Number: 38356 Primary Status: Current - Active

Address :
2233 E GARVEY AVE N
WEST COVINA CA 91791
LOS ANGELES COUNTY

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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: YAGHOUBI, EDMOND

License/Registration Type: Dentist License

License Number: 58304 Primary Status: Current - Active

Address :
1748 S Corning St
LOS ANGELES CA 90035-4302
LOS ANGELES COUNTY

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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: ROBLES, ARMINDA VIVIANA

License/Registration Type: Dentist License

License Number: 56506 Primary Status: Current - Active

Address :
5628 Van Buren Blvd
RIVERSIDE CA 92503-2080
RIVERSIDE COUNTY

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