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Licensing details for: 1299

Name: SMITH, TIMOTHY SHELBURNE

License Type: Dentist General Anesthesia

Primary Status: Current - Active

Address of Record

2878 CAMINO DEL RIO SOUTH
SUITE 210
SAN DIEGO CA 92108
SAN DIEGO county
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Issuance Date

June 25, 2004

Expiration Date

May 31, 2027

Current Date / Time

June 6, 2025
10:24:54 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: HAMMOND & SMITH MISSION VALLEY ORAL

License/Registration Type: Fictitious Name Permit

License Number: 1539 Primary Status: Expired

Address :
2878 CAMINO DEL RIO SOUTH, STE 210
SAN DIEGO CA 92108
SAN DIEGO COUNTY

Map

GA to DDS or OMS or SP

License/Registration Role: General Anesthesia Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: SMITH, TIMOTHY SHELBURNE

License/Registration Type: Dentist License

License Number: 23792 Primary Status: Current - Active

Address :
2878 CAMINO DEL RIO SOUTH
SUITE 210
SAN DIEGO CA 92108
SAN DIEGO COUNTY

Map

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