Dental Board of California
Licensing details for: 18297
Name: BLOOMFIELD DENTAL CENTER DENTAL OFFICE OF BALSHE 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: BALSHE, AYMAN ABDUL-LATIF
License/Registration Type: Dentist License
License Number: 57041 Primary Status: Current - Active
Address :
12657 166th St
CERRITOS CA 90703-2101
LOS ANGELES COUNTY
