Dental Board of California
Licensing details for: 3454
Name: PHAM, MINH BAO
License Type: Oral Conscious Sedation
Primary Status: Expired
Specialty: Adult
Address of Record
5663 BALBOA AVE SUITE 383
SAN DIEGO CA 92111
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BAY PARK SMILES DENTISTRY DENTAL GROUP HUYNH AND HABASHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15134 Primary Status: Current - Active
Address :
2995 CLAIREMONT DRIVE, SUITE A
SAN DIEGO CA 92117
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PB SMILES DENTISTRY DENTAL GROUP, S. ALVARDO AND M. PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17052 Primary Status: Current - Active
Address :
1975 GARNET AVENUE, SUITE E
SAN DIEGO CA 92109
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
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
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA JOLLA VILLAGE SMILES DENTISTRY DENTAL GROUP ALVARADO AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15202 Primary Status: Current - Active
Address :
4640 CASS ST UNIT 9720
LA JOLLA CA 92037
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP, MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16162 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SANTEE TOWN CENTER DENTAL GROUP JADALI-ARAGHI AND NOSTI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16654 Primary Status: Current - Active
Address :
246 TOWN CENTER PKWY
SANTEE CA 92071
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: GATEWAY DENTAL GROUP CLINTON PARK DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16770 Primary Status: Current - Active
Address :
2635 GATEWAY ROAD., SUITE 101
CARLSBAD CA 92009
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SANTEE SMILES DENTISTRY DENTAL GROUP JADALI-ARAGHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15163 Primary Status: Cancelled
Address :
9331 MISSION GORGE ROAD, SUITE 105
SANTEE CA 92071
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: TIERRASANTA DENTAL GROUP, HABASHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15139 Primary Status: Current - Active
Address :
10405 TIERRASANTA BLVD.
SAN DIEGO CA 92124
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DOWNTOWN SD MODERN DENTISTRY DENTAL GROUP DO-YABUT AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15136 Primary Status: Cancelled
Address :
435 4TH AVENUE
SAN DIEGO CA 92101
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: POWAY FAMILY DENTAL GROUP - MY KIDS DENTIST DALTON DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15160 Primary Status: Cancelled
Address :
13616 POWAY ROAD, SUITE 100
POWAY CA 92064
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CARLSBAD VILLAGE FAIRE DENTISTS DENTAL GROUP AMANDA MERCER AND DIANA DO-YABUT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15148 Primary Status: Cancelled
Address :
300 CARLSBAD VILLAGE DRIVE, SUITE 203
CARLSBAD CA 92008
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MY KID'S DENTIST DENTAL GROUP VINCENT TU DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15203 Primary Status: Current - Active
Address :
320 SYCAMORE AVENUE, SUITE 60
VISTA CA 92083
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CARLSBALD VILLAGE FAIRE DENTISTS DENTAL GROUP, DAVIS AND DO-YABUT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16476 Primary Status: Current - Active
Address :
300 CARLSBAD VILLAGE DRIVE SUITE 203
CARLSBAD CA 92008
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP, MERCER AND SHAKIL DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16657 Primary Status: Current - Active
Address :
3150 CASE ROAD BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SAN MARCOS DENTAL GROUP NOSTI AND REAGAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15129 Primary Status: Current - Active
Address :
709 CENTER DRIVE, SUITE 101
SAN MARCOS CA 92069-2502
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA JOLLA VILLAGE SMILES DENTISTRY DENTAL GROUP ALVARADO AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13146 Primary Status: Cancelled
Address :
8657 VILLA LA JOLLA DRIVE, SUITE 211
LA JOLLA CA 92037
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MENIFEE SMILES DENTISTRY DENTAL GROUP, CAROLYN GHAZAL AND MINH PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13788 Primary Status: Cancelled
Address :
30406 HAUN RD STE 740
MENIFEE CA 92584
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RANCHO SAN DIEGO DENTISTS DENTAL GROUP CHERYL TRAN, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 15170 Primary Status: Cancelled
Address :
3767 AVOCADO BLVD.
LA MESA CA 91941
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CANYON VISTA DENTAL GROUP - MY KIDS DENTIST SONAL SINGH DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15152 Primary Status: Current - Active
Address :
700 OTAY LAKES ROAD
CHULA VISTA CA 91910
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PACIFIC HIGHLANDS DENTISTRY DENTAL GROUP AND MY KID'S DENTIST JOHN C. NOSTI, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 15147 Primary Status: Current - Active
Address :
5965 VILLAGE WAY, SUITE E-206
SAN DIEGO CA 92130
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: EAST VILLAGE DENTAL GROUP MINH PHAM AND DIANA DO-YABUT DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15153 Primary Status: Cancelled
Address :
1455 G STREET
SAN DIEGO CA 92101
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RSD DENTAL GROUP CHERYL TRAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15162 Primary Status: Current - Active
Address :
2907 JAMACHA ROAD, SUITE B
EL CAJON CA 92019
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VILLAGE DENTAL GROUP SONAL SINGH, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 15109 Primary Status: Current - Active
Address :
878 EASTLAKE PARKWAY, SUITE 1511
CHULA VISTA CA 91914
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP, MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14059 Primary Status: Cancelled
Address :
3150 CASE RD BLDG C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SANTEE SMILES DENTISTRY DENTAL GROUP JADALI-ARAGHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15677 Primary Status: Current - Active
Address :
9331 MISSION GORGE ROAD., SUITE 105
SANTEE CA 92071
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PROMENADE DENTISTS DENTAL GROUP, AKBARI FARAHANI AND MERCER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16157 Primary Status: Cancelled
Address :
2710 VIA DE LA VALLE., SUITE B250
DEL MAR CA 92014
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA MESA MODERN DENTAL GROUP ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15132 Primary Status: Cancelled
Address :
5620 LAKE MURRAY BLVD
LA MESA CA 91942
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MISSION HILLS DENTAL GROUP BABAK ARIANNEJAD DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15145 Primary Status: Current - Active
Address :
718 W. WASHINGTON STREET
SAN DIEGO CA 92103
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: COLLEGE DENTAL GROUP, ROGERS AND REAGAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15158 Primary Status: Current - Active
Address :
467 COLLEGE BLVD., SUITE 2
OCEANSIDE CA 92057
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: EASTLAKE MODERN DENTISTRY DENTAL GROUP, NAVEJAS CARPIO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 19088 Primary Status: Current - Active
Address :
1690 MILLENIA AVE., SUITE 102
CHULA VISTA CA 91915
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CLAIREMONT SMILES DENTISTRY DENTAL GROUP MINH PHAM AND STEVEN ALVARADO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14825 Primary Status: Current - Active
Address :
5675 BALBOA AVE
SAN DIEGO CA 92111
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP MERCER AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14526 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PERRIS MODERN DENTISTRY DENTAL GROUP SOHAL AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13517 Primary Status: Current - Active
Address :
1820 PERRIS BLVD STE 70
PERRIS CA 92571
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CAMINO DENTAL GROUP CLINTON PARK, D.D.S., INC.
License/Registration Type: Fictitious Name Permit
License Number: 15142 Primary Status: Current - Active
Address :
1340 ENCINITAS BLVD., SUITE 100
ENCINITAS CA 92024
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CROSSING DENTAL GROUP MERCER AN PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15215 Primary Status: Cancelled
Address :
3150 CASE ROAD, BUILDING C
PERRIS CA 92570
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: NORTH PARK MODERN DENTISTRY DENTAL GROUP HINDERBERGER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15539 Primary Status: Current - Active
Address :
2050 EL CAJON BLVD
SAN DIEGO CA 92104
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA MESA MODERN DENTAL GROUP,, ARIANNEJAB AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17946 Primary Status: Current - Active
Address :
5620 LAKE MURRAY BLVD
LA MESA CA 91942
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PROMADE DENTISTS DENTAL GROUP, JUSTIN MERCER DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 17264 Primary Status: Current - Active
Address :
2710 VIA DE LA VALLE, SUITE B250
DEL MAR CA 92014
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VISTA DENTAL GROUP, DARREN DO DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15133 Primary Status: Current - Active
Address :
435 S. MELSORSE DRIVE, SUITE 105
VISTA CA 92084
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA COSTA DENTISTRY DENTAL GROUP MOBASHER AND NOSTI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15143 Primary Status: Expired
Address :
7625 VIA CAMPANILE, SUITE 130
CARLSBAD CA 92009
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LAS POSAS DENTAL PRACTICE, TRAN AND NOSTI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15131 Primary Status: Current - Active
Address :
145 S. LAS POSAS ROAD, SUITE 162
SAN MARCOS CA 92078
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MENIFEE SMILES DENTISTRY DENTAL GROUP CAROLYN GHAZAL AND MINH PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15684 Primary Status: Current - Active
Address :
30406 HAUN ROAD., SUITE 740
MENIFEE CA 92584
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: LA MESA MODERN DENTAL GROUP ARIANNEJAD AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13249 Primary Status: Cancelled
Address :
5620 LAKE MURRAY BLVD.
LA MESA CA 91942
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: ESCONDIDO SMILES DENTISTRY DENTAL GROUP BOCASH AND NOSTI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15137 Primary Status: Current - Active
Address :
860 W. VALLEY PKWY., SUITE 100
ESCONDIDO CA 92025
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PB SMILES DENTISTRY DENTAL GROUP NOSTI AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15365 Primary Status: Cancelled
Address :
1975 GARNET AVENUE, SUITE E
SAN DIEGO CA 92109
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: QUARRY CREEK DENTAL GROUP DART AND SHARIFIAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15164 Primary Status: Current - Active
Address :
3430 MARRON ROAD, SUITE 300
OCEANSIDE CA 92056
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: STONECREST DENTAL GROUP PATEL AND HABASHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15019 Primary Status: Cancelled
Address :
3737 MURPHY CANYON ROAD, SUITE C-2
SAN DIEGO CA 92123
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PROMENADE DENTISTS DENTAL GROUP STANISAI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15166 Primary Status: Cancelled
Address :
2710 VIA DE LA VALLE, SUITE B250
DEL MAR CA 92014
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: BERNARDO HEIGHTS DENTAL GROUP, PIRASTEHFAR AND HABASHI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15191 Primary Status: Current - Active
Address :
15731 BERNARDO HEIGHTS PKWY., SUITE 101
SAN DIEGO CA 92128
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: CARMEL VALLEY DENTIST OFFICE DENTAL GROUP NAZARENO AND NOSTI DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15496 Primary Status: Current - Active
Address :
5550 CARMEL MOUNTAIN ROAD, SUITE 101
SAN DIEGO CA 92130
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: POWAY FAMILY DENTAL GROUP, JAISWAL AND DALTON DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16481 Primary Status: Current - Active
Address :
13616 POWAY RD STE 100
POWAY CA 92064
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: PB SMILES DENTISTRY DENTAL GROUP SALEHPOUR AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 13148 Primary Status: Cancelled
Address :
1975 GARNET AVENUE, SUITE E
SAN DIEGO CA 92109
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KENSINGTON DENTAL GROUP, LE AND PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15140 Primary Status: Current - Active
Address :
4142 ADAMS AVENUE, SUITE 104
SAN DIEGO CA 92116
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: MENIFEE SMILES DENTISTRY DENTAL GROUP CAROLYN GHAZAL AND MINH PHAM DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15154 Primary Status: Cancelled
Address :
30406 HAUN ROAD, SUITE 740
MENIFEE CA 92584
RIVERSIDE COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: SOUTH OCEANSIDE DENTAL GROUP BOCASH AND SHARIFIAN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15128 Primary Status: Current - Active
Address :
2484 VISTA WAY, SUITE B
OCEANSIDE CA 92054
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: VISTA MODERN DENTISTRY DENTAL GROUP RONNY LE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 15414 Primary Status: Cancelled
Address :
1350 E. VISTA WAY., SUITE 10
VISTA CA 92084
SAN DIEGO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RANCHO SAN DIEGO DENTISTS DENTAL GROUP, JESSICA NGUYEN DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 16554 Primary Status: Current - Active
Address :
3767 AVOCADO BLVD
LA MESA CA 91941
SAN DIEGO 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: PHAM, MINH BAO
License/Registration Type: Dentist License
License Number: 46321 Primary Status: Expired
Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO COUNTY
