Dental Board of California
Licensing details for: 3192
Name: SAN GABRIEL DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Sole Owner
Address of Record
3534 W BEVERLY BLVD
MONTEBELLO CA 90640
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: REYES, MARTIN GABRIEL
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: REYES, MARTIN GABRIEL
License/Registration Type: Dentist License
License Number: 46945 Primary Status: Current - Active
Address :
3534 W Beverly Blvd
MONTEBELLO CA 90640-1541
LOS ANGELES COUNTY
