Dental Board of California
Licensing details for: 18253
Name: TRI-CITY DENTAL EXCELLENCE DENTAL GROUP PRACTICE OF PANAH, A. D.D.S. A PROFESSIONAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Expired
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: RASTEGAR-PANAH, ARASH
License/Registration Type: Dentist License
License Number: 48000 Primary Status: Current - Active
Address :
1836 6TH STREET
MANHATTAN BEACH CA 90266
LOS ANGELES COUNTY
