Dental Board of California
Licensing details for: 63511
Name: LAU, KENT
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
415 Santa Fe Dr
Encinitas Smiles Dentistry
ENCINITAS CA 92024-5134
SAN DIEGO 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: LAU AND PARK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79713 Primary Status: Cancelled
Address :
415 SANTA FE DRIVE
ENCINITAS CA 92024
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: LAU AND PARK DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 80199 Primary Status: Current - Active
Address :
415 SANTA FE DRIVE
ENCINITAS CA 92024
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: ENCINITAS SMILES DENTISTRY DENTAL GROUP LAU AND PARK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14293 Primary Status: Cancelled
Address :
415 SANTA FE DRIVE
ENCINITAS CA 92024
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: ENCINITAS SMILES DENTISTRY DENTAL GROUP LAU AND PARK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15138 Primary Status: Current - Active
Address :
415 SANTA FE DRIVE
ENCINITAS CA 92024
SAN DIEGO COUNTY
