Dental Board of California
Licensing details for: 19068
Name: SAN JUAN FAMILY DENTISTRY, DENTAL OFFICE OF DR. LEILA KHAMSEI
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KHAMSEI, LEILA
Address Not Disclosed
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: KHAMSEI, LEILA
License/Registration Type: Dentist License
License Number: 54594 Primary Status: Current - Active
Address :
5 Irish Moss St
LADERA RANCH CA 92694-0746
ORANGE COUNTY
