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Licensing details for: 8715

Name: MARKET WEST DENTAL GROUP, PATEL AND GHAZAL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: MARKET WEST DENTAL GROUP AND ORTHODONTICS, PATEL AND GHAZAL DENTA MARKET WEST DENTAL GROUP

Address of Record

3290 ARENA BLVD.
STE. 610
SACRAMENTO CA 95834
SACRAMENTO county
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Issuance Date

May 12, 2010

Expiration Date

February 28, 2017

Current Date / Time

June 6, 2025
10:2:19 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHAZAL, CAROLYN G

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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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