
Dental Board of California
Licensing details for: 9261
Name: SMILE DENTAL PRACTICE, DR. M. MAZLOOM
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: SMILE DENTAL PRACTICE DR M MAZLOOM
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAZLOOM, MORTEZA
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: MAZLOOM, MORTEZA
License/Registration Type: Dentist License
License Number: 49596 Primary Status: Current - Active
Address :
5370 Hollister Ave
Suite A
SANTA BARBARA CA 93111-2303
SANTA BARBARA COUNTY