Dental Board of California
Licensing details for: 4117
Name: AUBURN DENTAL ASSOCIATES, DR MAZLOOM DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: AUBURN DENTAL ASSOCIATES, DR MAZLOON DENTAL PRACTICE
Address of Record
1915 GRASS VALLEY HWY, #200
AUBURN CA 95603
PLACER county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAZLOOM, MORTEZA
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAZLOON, MARTEZA
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: MAZLOOM, MORTEZA
License/Registration Type: Dentist License
License Number: 49596 Primary Status: Current - Active
Address :
5370 Hollister Ave
Suite A
SANTA BARBARA CA 93111-2303
SANTA BARBARA COUNTY
