Dental Board of California
Licensing details for: 64009
Name: PARK, JOSEPH
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Address of Record
925 W Foothill Blvd Ste C
MONROVIA CA 91016-1930
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: Joseph Park DDS Inc
License/Registration Type: Fictitious Name Permit
License Number: 17391 Primary Status: Current - Active
Address :
925 W FOOTHILL BLVD STE C
MONROVIA CA 91016-1930
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: SPROUT PEDIATRIC DENTISTRY, DENTAL PRACTICE OF JOSEPH PARK DDS INC
License/Registration Type: Fictitious Name Permit
License Number: 17391 Primary Status: Current - Active
Address :
925 W FOOTHILL BLVD STE C
MONROVIA CA 91016-1930
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: PARK, JOSEPH
License/Registration Type: Oral Conscious Sedation Certificate
License Number: 3601 Primary Status: Cancelled
Address :
925 W Foothill Blvd Ste C
MONROVIA CA 91016-1930
LOS ANGELES COUNTY
