Dental Board of California
Licensing details for: 2814
Name: PEDIATRIC DENTISTRY AND DENTAL I.V.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Partnership
Address of Record
5400 BALBOA BLVD #308
ENCINO CA 91316
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KIRSHBAUM, GERALD M
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GROPER, JOHN N
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: KIRSHBAUM, GERALD M
License/Registration Type: Dentist License
License Number: 17110 Primary Status: Current - Active
Address :
4698 Park Mirasol
CALABASAS CA 91302-1731
LOS ANGELES COUNTY
