Dental Board of California
Licensing details for: 5824
Name: SMILE SELECT HACIENDA HEIGHTS DENTAL OFFICE,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
17188 E COLIMA RD, STE B
HACIENDA HEIGHTS CA 91745
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHETTY, SWATI
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: SHETTY, SWATI
License/Registration Type: Dentist License
License Number: 50587 Primary Status: Current - Active
Address :
17160 Colima Rd Ste C
HACIENDA HEIGHTS CA 91745-6785
LOS ANGELES COUNTY
