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Licensing details for: 10887

Name: CHIEU PHAM DDS

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Sole Owner

Address of Record

16918 DOVE CANYON ROAD
SUITE 203
SAN DIEGO CA 92127
SAN DIEGO county
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Practice Location

16918 DOVE CANYON RD #203
SAN DIEGO CA 92127
SAN DIEGO county
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Issuance Date

December 20, 2012

Expiration Date

August 31, 2023

Current Date / Time

June 6, 2025
2:20:18 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: PHAM, CHIEU L

License/Registration Type: Dentist License

License Number: 52916 Primary Status: Current - Active

Address :
2015 Birch Rd Ste 103
CHULA VISTA CA 91915-2003
SAN DIEGO COUNTY

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