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Licensing details for: 7966

Name: MESA DENTAL GROUP, JAMES BRODFUEHRER, DDS, A DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: MESA DENTAL GROUP

Address of Record

9225 MIRA MESA BOULEVARD
STE. 212
SAN DIEGO CA 92126
SAN DIEGO county
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Practice Location

9225 MIRA MESA BOULEVARD
STE. 212
SAN DIEGO CA 92126
SAN DIEGO county
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Issuance Date

February 2, 2009

Expiration Date

February 28, 2027

Current Date / Time

June 6, 2025
9:54:44 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BRODFUEHRER, JAMES SEAN

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: BRODFUEHRER, JAMES SEAN

License/Registration Type: Dentist License

License Number: 37535 Primary Status: Current - Active

Address :
9225 Mira Mesa Blvd
SUITE 212
SAN DIEGO CA 92126-4820
SAN DIEGO COUNTY

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