Dental Board of California
Licensing details for: 4737
Name: KINGS FAMILY DENTAL GROUP FOR SIMON MASOOD IMANUEL, DMD, INC
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Secondary Status: Cancelled at the Request of the Licensee
Address of Record
14124 FOOTHILL BLVD, STE 103
SYLMAR CA 91342
LOS ANGELES county
Map
License Relationships
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: IMANUEL, SIMON MASOOD
License/Registration Type: Dentist License
License Number: 39418 Primary Status: Current - Active
Address :
14114 Polk Street
SYLMAR CA 91342
LOS ANGELES COUNTY
