Dental Board of California
Licensing details for: 3042
Name: GROVE DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
6963 BROADWAY
LEMON GROVE CA 91945
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MANJI, MEHMOOD FATEHALI
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: 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
