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Licensing details for: 2810

Name: POWAY FAMILY DENTAL CENTER

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

15706 POMERADO ROAD SUITE 201
POWAY CA 92064
SAN DIEGO county
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Issuance Date

July 10, 2000

Expiration Date

June 30, 2004

Current Date / Time

December 13, 2025
7:53:31 AM

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: MICHELS, ALAN G

License/Registration Type: Dentist License

License Number: 19777 Primary Status: Current - Active

Address :
3529 Castleman Ln
BURBANK CA 91504-1663
LOS ANGELES COUNTY

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