Dental Board of California
Licensing details for: 1788
Name: TAN, MINTRA
License Type: Oral Conscious Sedation
Primary Status: Cancelled
Specialty: Minor
Address of Record
151 S Mednik Ave
LOS ANGELES CA 90022-1606
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CHILDREN'S DENTAL PLANET, DENTAL GROUP OF TAN, DDS AND TRAN, DDS,
License/Registration Type: Fictitious Name Permit
License Number: 10523 Primary Status: Current - Active
Address :
151 S. MEDNIK AVENUE
LOS ANGELES CA 90022
LOS ANGELES COUNTY
OCS to DDS, OMS, or SP
License/Registration Role: Oral Conscious Sedation Certificate
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: TAN, MINTRA
License/Registration Type: Dentist License
License Number: 53108 Primary Status: Current - Active
Address Not Disclosed
