Dental Board of California
Licensing details for: 20967
Name: Van Buren Modern Dentistry, Dental Group of Van Buren Modern Dentistry, Prof. Corp.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
20115 Van Buren Blvd.STE 100
RIVERSIDE CA 92508
Map
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: ZAKLAMA, KARIM MAGID
License/Registration Type: Dentist License
License Number: 61349 Primary Status: Current - Active
Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES 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: DHAMA, DEEPIKA S
License/Registration Type: Dentist License
License Number: 49044 Primary Status: Current - Active
Address :
2044 California Ave
CORONA CA 92881-3300
RIVERSIDE 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: MERCER, JUSTIN WILLIAM
License/Registration Type: Dentist License
License Number: 59375 Primary Status: Current - Active
Address :
3150 Case Rd Bldg C
PERRIS CA 92570-5552
RIVERSIDE 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: WON, ANDREW JAY
License/Registration Type: Dentist License
License Number: 63150 Primary Status: Current - Active
Address :
8715 Trautwein Rd
Suite A
RIVERSIDE CA 92508-9474
RIVERSIDE 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: SHAIKH, MOHAMMED TAUQUEER
License/Registration Type: Dentist License
License Number: 107814 Primary Status: Current - Active
Address :
20115 Van Buren Blvd
Suite 100
RIVERSIDE CA 92508
RIVERSIDE COUNTY
