Dental Board of California
Licensing details for: 352
Name: CHILDREN & PREVEN BAKER FARAJZADEH
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Partnership
Address of Record
15835 POMERADO ROAD STE 101
POWAY CA 92064
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: BAKER, BRUCE BAKHSHI
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: BAKER, BRUCE BAKHSHI
License/Registration Type: Dentist License
License Number: 32267 Primary Status: Voluntary Surrendered
Address :
PO BOX 669
POWAY CA 92074
SAN DIEGO COUNTY
