Dental Board of California
Licensing details for: 18077
Name: FAMILY DENTAL PRACTICE OF LANCASTER DENTAL OFFICE OF FARID PAKRAVAN PROFESSIONAL DENTAL CORP.
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: SAREH, ATEFEH
License/Registration Type: Dentist License
License Number: 41993 Primary Status: Current - Active
Address :
12121 Wilshire Blvd
Suite 1111
LOS ANGELES CA 90025-1123
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: PAKRAVAN, FARID
License/Registration Type: Dentist License
License Number: 39862 Primary Status: Current - Active
Address :
2604 S VERMONT AVE
SUITE F
LOS ANGELES CA 90007
LOS ANGELES COUNTY
