Dental Board of California
Licensing details for: 103040
Name: YUAN, YI
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
585 Saturn Blvd
Suite C
SAN DIEGO CA 92154-4721
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KIDZ SHINE DENTAL DENTAL OFFICE OF DR. YI YUAN
License/Registration Type: Fictitious Name Permit
License Number: 18787 Primary Status: Current - Active
Address :
585 SATURN BLVD, STE C
SAN DIEGO CA 92154
SAN DIEGO COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: KIDZ SHINE DENTAL DENTAL OFFICE OF DR. YI YUAN
License/Registration Type: Fictitious Name Permit
License Number: 18787 Primary Status: Current - Active
Address :
585 SATURN BLVD, STE C
SAN DIEGO CA 92154
SAN DIEGO COUNTY
PMS to DDS or OMS or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Pediatric Minimal Sedation Permit
Name: YUAN, YI
License/Registration Type: Pediatric Minimal Sedation Permit
License Number: 212 Primary Status: Current - Active
Address :
585 Saturn Blvd
Suite C
SAN DIEGO CA 92154-4721
SAN DIEGO COUNTY
