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Licensing details for: 18304

Name: DENTISTS OF OLD TORRANCE DENTAL GROUP, MEGAN MOSHAR DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1790 W. CARSON STREET, SUITE A
TORRANCE CA 90501
LOS ANGELES county
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Practice Location

1790 W. CARSON STREET, SUITE A
TORRANCE CA 90501
LOS ANGELES county
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Issuance Date

December 18, 2023

Expiration Date

January 31, 2026

Current Date / Time

December 15, 2025
9:2:15 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: JEFFERSON, WALTER

License/Registration Type: Dentist License

License Number: 53460 Primary Status: Current - Active

Address :
16475 SIERRA LAKES PKWY
STE 140
FONTANA CA 92336
SAN BERNARDINO 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: OATES, CHRISTOPHER COLLINS

License/Registration Type: Dentist License

License Number: 58874 Primary Status: Current - Active

Address :
1559 Pacific Coast Hwy
Ste 101
HERMOSA BEACH CA 90254-3214
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: MOSHAR, MEGAN ASHLEY

License/Registration Type: Dentist License

License Number: 63980 Primary Status: Current - Active

Address :
1790 W Carson St
Ste. A
TORRANCE CA 90501-7802

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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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
13528 Lakewood Blv
BELLFLOWER CA 90706

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