License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: DAVID R WYNDHAMSMITH & MICHAEL D KIM, A PROFESSIONAL
License/Registration Type: Additional Office Permit
License Number: 8521 Primary Status: Cancelled
Address :
512 VIA DE LA VALLE, STE 101
SOLANA BEACH CA 92075
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: WYNDHAMSMITH AND KIM, DDS, INC
License/Registration Type: Additional Office Permit
License Number: 7893 Primary Status: Cancelled
Address :
639 S ESCONDIDO BLVD
ESCONDIDO CA 92025
SAN DIEGO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: MICHAEL D KIM, DDS
License/Registration Type: Additional Office Permit
License Number: 5702 Primary Status: Cancelled
Address :
23838 VALENCIA BLVD
SUITE 301
VALENCIA CA 91355
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VALENCIA DENTAL CARE, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 1501 Primary Status: Cancelled
Address :
DRS WYNDHAMSMITH & KIM
23838 VALENCIA BLVD, STE 301
VALENCIA CA 91355
LOS ANGELES COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ACACIA DENTAL CARE, DENTAL PRACTICE OF
License/Registration Type: Fictitious Name Permit
License Number: 4095 Primary Status: Cancelled
Address :
639 S ESCONDIDO BLVD
ESCONDIDO CA 92025
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DEL MAR DENTAL GROUP, DAVID R WYNDHAMSMITH AND MICHAEL D
License/Registration Type: Fictitious Name Permit
License Number: 5547 Primary Status: Cancelled
Address :
512 VIA DE LA VALLE, STE 101
SOLANA BEACH CA 92075
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VALENCIA DENTAL CARE,DENTAL PRACTICE OF DAVID R.WYNDHAMSMITH, DDS
License/Registration Type: Fictitious Name Permit
License Number: 1971 Primary Status: Cancelled
Address :
23838 VALENCIA BLVD.
SUITE 301
VALENCIA CA 91355
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: DEL MAR DENTAL GROUP, DAVID R WYNDHAMSMITH AND MICHAEL D
License/Registration Type: Fictitious Name Permit
License Number: 5547 Primary Status: Cancelled
Address :
512 VIA DE LA VALLE, STE 101
SOLANA BEACH CA 92075
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: VALENCIA DENTAL CARE,DENTAL PRACTICE OF DAVID R.WYNDHAMSMITH, DDS
License/Registration Type: Fictitious Name Permit
License Number: 1971 Primary Status: Cancelled
Address :
23838 VALENCIA BLVD.
SUITE 301
VALENCIA CA 91355
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: ACACIA DENTAL CARE, DENTAL PRACTICE OF
License/Registration Type: Fictitious Name Permit
License Number: 4095 Primary Status: Cancelled
Address :
639 S ESCONDIDO BLVD
ESCONDIDO CA 92025
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: VALENCIA DENTAL CARE, DENTAL PRACTICE
License/Registration Type: Fictitious Name Permit
License Number: 1501 Primary Status: Cancelled
Address :
DRS WYNDHAMSMITH & KIM
23838 VALENCIA BLVD, STE 301
VALENCIA CA 91355
LOS ANGELES COUNTY
