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Licensing details for: 3454

Name: PHAM, MINH BAO

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Address of Record

5663 BALBOA AVE SUITE 383
SAN DIEGO CA 92111
SAN DIEGO county
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Issuance Date

March 25, 2016

Expiration Date

April 30, 2027

Current Date / Time

December 13, 2025
3:34:27 PM

License Relationships

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: PHAM, MINH BAO

License/Registration Type: Dentist License

License Number: 46321 Primary Status: Current - Active

Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO COUNTY

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