Dental Board of California
Licensing details for: 3204
Name: PACIFIC DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
310 THIRD AVENUE #C-1B
CHULA VISTA CA 91910
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAROON, JOHN PAUL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: HOSSEINI-MAROON, MANIJEH
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: HOSSEINI-MAROON, MANIJEH
License/Registration Type: Dentist License
License Number: 40946 Primary Status: Current - Active
Address :
310 Third Ave Ste C1B
CHULA VISTA CA 91910-3954
SAN DIEGO COUNTY
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: MAROON, JOHN PAUL
License/Registration Type: Dentist License
License Number: 40671 Primary Status: Current - Active
Address :
310 THIRD AVE
SUITE C-1B
CHULA VISTA CA 91910
SAN DIEGO COUNTY
