Dental Board of California
Licensing details for: 104634
Name: QIU, HENRY
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: 5D SMILES DENTAL PRACTICE OF HENRY QIU, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 17408 Primary Status: Expired
Address :
8500 FLORENCE AVE., SUITE 100
DOWNEY CA 90240
LOS ANGELES 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: 5D SMILES DENTAL PRACTICE OF HENRY QIU, DDS, INC.
License/Registration Type: Fictitious Name Permit
License Number: 17408 Primary Status: Expired
Address :
8500 FLORENCE AVE., SUITE 100
DOWNEY CA 90240
LOS ANGELES COUNTY
