Dental Board of California
Licensing details for: 2002
Name: AMISTAD DENTAL OFFICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Address of Record
1028 WEST FIRST STREET
SUITE E
SANTA ANA CA 92703
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DESAI, AMIT J
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: DESAI, AMIT J
License/Registration Type: Dentist License
License Number: 42538 Primary Status: Current - Active
Address :
8224 JOSHUA CIRCLE
BUENA PARK CA 90620
ORANGE COUNTY
