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Licensing details for: 2972

Name: VISTA FAMILY DENTAL PRACTICE OF

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

985 S SANTA FE SUITE 5
VISTA CA 92803
SAN DIEGO county
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Issuance Date

November 27, 2000

Expiration Date

May 30, 2005

Current Date / Time

December 13, 2025
7:53:21 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: MANJI, MEHMOOD FATEHALI

License/Registration Type: Dentist License

License Number: 46109 Primary Status: Current - Active

Address :
467 College Blvd
Suite 2
OCEANSIDE CA 92057-5436

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