Dental Board of California
Licensing details for: 4426
Name: PALM DENTAL, FARHOUD RASTEGAR, DDS, DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: PALM DENTAL, FARHOUD RASTIGAR, DDS, DENTAL PRACTICE
Address of Record
3320 PALM AVE, STE B
SAN DIEGO CA 92154
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RASTEGAR, FARHOUD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: RASTIGAR, FARHOUD
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: RASTEGAR, FARHOUD
License/Registration Type: Dentist License
License Number: 42597 Primary Status: Current - Active
Address :
1450 Frazee Rd
SUITE 209
SAN DIEGO CA 92108-4337
SAN DIEGO COUNTY
