Dental Board of California
Licensing details for: 23792
Name: SMITH, TIMOTHY SHELBURNE
License Type: Dentist
Primary Status: Current - Active
Secondary Status: Probation Terminated ❖ Reduced Renewal Fee
Address of Record
2878 CAMINO DEL RIO SOUTH
SUITE 210
SAN DIEGO CA 92108
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: HAMMOND & SMITH MISSION VALLEY ORAL
License/Registration Type: Fictitious Name Permit
License Number: 1539 Primary Status: Expired
Address :
2878 CAMINO DEL RIO SOUTH, STE 210
SAN DIEGO CA 92108
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: HAMMOND & SMITH MISSION VALLEY ORAL
License/Registration Type: Fictitious Name Permit
License Number: 1539 Primary Status: Expired
Address :
2878 CAMINO DEL RIO SOUTH, STE 210
SAN DIEGO CA 92108
SAN DIEGO COUNTY
GA 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: General Anesthesia Permit
Name: SMITH, TIMOTHY SHELBURNE
License/Registration Type: General Anesthesia Permit
License Number: 1299 Primary Status: Current - Active
Address :
2878 CAMINO DEL RIO SOUTH
SUITE 210
SAN DIEGO CA 92108
SAN DIEGO COUNTY
GA 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: General Anesthesia Permit
Name: SMITH, TIMOTHY SHELBURNE
License/Registration Type: General Anesthesia Permit
License Number: 993 Primary Status: Revoked
Address :
2878 CAMINO DEL RIO SOUTH
SUITE 210
SAN DIEGO CA 92108
SAN DIEGO COUNTY
