Dental Board of California
Licensing details for: 8448
Name: GARDENA FAMILY DENTAL PRACTICE OF KIYOMI YAMAZAKI, DDS, INC.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: GARDENA FAMILY DENTAL
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: YAMAZAKI, KIYOMI
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: YAMAZAKI, KIYOMI
License/Registration Type: Dentist License
License Number: 52484 Primary Status: Current - Active
Address :
1143 W Gardena Blvd
GARDENA CA 90247-4823
LOS ANGELES COUNTY
