Dental Board of California
Licensing details for: 60179
Name: LEE, SEUNG JAE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
3779 E Castro Valley Blvd
CASTRO VALLEY CA 94552-4835
SAN FRANCISCO county
Map
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: SEUNG LEE DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 81519 Primary Status: Current - Active
Address :
948 DIABLO AVENUE
NOVATO CA 94947
MARIN COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: NOVATO SMILES DENTISTRY DENTAL GROUP, SEUNG LEE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17844 Primary Status: Current - Active
Address :
948 DIABLO AVENUE
NOVATO CA 94947
MARIN 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: NOVATO SMILES DENTISTRY DENTAL GROUP, SEUNG LEE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17844 Primary Status: Current - Active
Address :
948 DIABLO AVENUE
NOVATO CA 94947
MARIN COUNTY
