Dental Board of California
Licensing details for: 7643
Name: COPPER CANYON SMILES, DENTAL OFFICE OF POURSHIRAZI DENTAL CORP.
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: COPPER CANYON SMILE
Address of Record
23771 WASHINGTON AVENUE
STE. H-102
MURRIETA CA 92562
RIVERSIDE 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: POURSHIRAZI, HOMAYOUN
License/Registration Type: Dentist License
License Number: 44064 Primary Status: Current - Active
Address :
27192 Newport Rd
SUITE 2
MENIFEE CA 92584-7387
RIVERSIDE COUNTY
