Dental Board of California
Licensing details for: 55500
Name: PHAM, KIM THU
License Type: Dentist
Primary Status: Current - Active
Previous Names: PHAM, KIM T
License Relationships
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: HUNTINGTON BEACH FAMILY DENTAL, OFFICE OF KIM T. PHAM, D.M.D. & M
License/Registration Type: Fictitious Name Permit
License Number: 11151 Primary Status: Cancelled
Address :
18700 MAIN STREET
SUITE 207
HUNTINGTON BEACH CA 92648
ORANGE 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: AMORE FAMILY DENTAL DENTAL GROUP OF KIM T PHAM & MICHAEL J SCAMURRA DMD DENTAL CORPORATION INC
License/Registration Type: Fictitious Name Permit
License Number: 13014 Primary Status: Cancelled
Address :
2690 PACIFIC AVENUE, SUITE 360
LONG BEACH CA 90806
LOS ANGELES COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Related Party Role: Oral Conscious Sedation Certificate
Name: PHAM, KIM THU
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 2945 Primary Status: Cancelled
Address :
3946
Walnut Avenue
LONG BEACH CA 90807
LOS ANGELES COUNTY
