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Licensing details for: 10821

Name: SOPHEAP TANG, DMD, DENTAL CORP.

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

31577 CANYON ESTATES DR.
STE. 200
LAKE ELSINORE CA 92532
RIVERSIDE county
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Issuance Date

September 21, 2012

Expiration Date

May 31, 2026

Current Date / Time

December 13, 2025
9:47:28 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: TANG, SOPHEAP

License/Registration Type: Dentist License

License Number: 56393 Primary Status: Current - Active

Address :
18876 Van Buren Blvd.
STE 107
RIVERSIDE CA 92508
RIVERSIDE COUNTY

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