Dental Board of California
Licensing details for: 4471
Name: PLAZA DENTAL CLINIC, DENTAL OFFICE OF
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
7028 1/2 VAN NUYS BLVD
VAN NUYS CA 91405
LOS ANGELES county
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License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: AHMADZADEH, FARIBA
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: AHMADZADEH, FARIBA
License/Registration Type: Dentist License
License Number: 45349 Primary Status: Current - Active
Address :
7028 1/2 Van Nuys Blvd
VAN NUYS CA 91405-3059
LOS ANGELES COUNTY
