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Licensing details for: 10373

Name: NA DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

6912 BROCKTON AVENUE
RIVERSIDE CA 92506
RIVERSIDE county
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Practice Location

6912 BROCKTON AVENUE
RIVERSIDE CA 92506
RIVERSIDE county
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Issuance Date

January 26, 2011

Expiration Date

November 30, 2013

Current Date / Time

June 6, 2025
2:19:15 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: NA, SANG EUN

License/Registration Type: Dentist License

License Number: 50791 Primary Status: Current - Active

Address :
8382 FOX HILLS AVE
BUENA PARK CA 90621
ORANGE COUNTY

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