Dental Board of California
Licensing details for: 19191
Name: ANTIOCH KIDS DENTAL STUDIO DENTAL GROUP OF ABDELAZIZ SAMI AND MAHDI
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: ABDELAZIZ, AMR A
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SAMI, HAITHAM ASHRAF
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAHDI, AMAR M
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: MAHDI, AMAR M
License/Registration Type: Dentist License
License Number: 65319 Primary Status: Current - Active
Address :
9141 E Stockton Blvd
230
9141 E. STOCKTON BLVD STE230
ELK GROVE CA 95624-9502
SACRAMENTO COUNTY
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: SAMI, HAITHAM ASHRAF
License/Registration Type: Dentist License
License Number: 65326 Primary Status: Current - Active
Address :
249 california st
Suit 6
WOODLAND CA 95695
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: ABDELAZIZ, AMR A
License/Registration Type: Dentist License
License Number: 105991 Primary Status: Current - Active
Address :
6237 Ravenna Way
ELK GROVE CA 95757-2814
SACRAMENTO COUNTY
