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Licensing details for: 5164

Name: WILMINGTON DENTAL! A DENTAL OFFICE OF FRATT DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1610 N. AVALON BLVD.
WILMINGTON CA 90744
LOS ANGELES county
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Issuance Date

September 8, 2004

Expiration Date

July 31, 2011

Current Date / Time

December 13, 2025
3:38:10 PM

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: FRATT, DENNIS R

License/Registration Type: Dentist License

License Number: 24779 Primary Status: Expired

Address :
1005 BAYSIDE COVE
NEWPORT BEACH CA 92660
ORANGE COUNTY

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