Dental Board of California
Licensing details for: 4482
Name: SAN JUAN FAMILY DENTISTRY, DENTAL OFFICE OF
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
31952 CAMINO CAPISTRANO
STE C14 & C16
SAN JUAN CAPISTRANO CA 92675
ORANGE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MEHRVARZI, MEHRDOKHT
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: MEHRVARZI, MEHRDOKHT
License/Registration Type: Dentist License
License Number: 39184 Primary Status: Current - Active
Address :
PO Box 16716
IRVINE CA 92623-6716
ORANGE COUNTY
