Dental Board of California
Licensing details for: 4448
Name: CENTRO MEDICO AND DENTAL FAMILIAR DENTAL PRACTICE,
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Sole Owner
Address not disclosed
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SOUCHITSKI, ANDREI
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: SOUCHITSKI, ANDREI
License/Registration Type: Dentist License
License Number: 43249 Primary Status: Current - Active
Address :
514 E WASHINGTON BLVD
LOS ANGELES CA 90015
LOS ANGELES COUNTY
