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Licensing details for: 8910

Name: FIFTH AVENUE DENTAL ARTS, DENTAL PRACTICE OF R. GHASSEMI, DDS, MS

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: FIFTH AVENUE DENTAL ARTS

Address of Record

450 A STREET
STE. 200
SAN DIEGO CA 92101
SAN DIEGO county
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Issuance Date

September 3, 2010

Expiration Date

August 31, 2014

Current Date / Time

June 6, 2025
1:59:43 AM

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: GHASSEMI-AVAL, ALI REZA

License/Registration Type: Dentist License

License Number: 40595 Primary Status: Current - Active

Address :
450 A St
STE 200
SAN DIEGO CA 92101-4274
SAN DIEGO COUNTY

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