Dental Board of California
Licensing details for: 19144
Name: MORENO VALLEY DENTIST DENTAL OFFICE OF DR. NIA
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: NIA, SINA
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: NIA, SINA
License/Registration Type: Dentist License
License Number: 101138 Primary Status: Current - Active
Address :
12810 Heacock St.
Suite B103
MORENO VALLEY CA 92553
RIVERSIDE COUNTY
