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Licensing details for: 11119

Name: MINH B. PHAM, D.D.S., INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: KATAYOUN AFSHAR DENTAL CORPORATION

Address of Record

5675 BALBOA AVENUE
SAN DIEGO CA 92111
SAN DIEGO county
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Practice Location

5675 BALBOA AVENUE
SAN DIEGO CA 92111
SAN DIEGO county
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Issuance Date

June 14, 2013

Expiration Date

March 31, 2015

Current Date / Time

June 7, 2025
8:58:23 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: RYGG, LANCE CHRISTIAN

License/Registration Type: Dentist License

License Number: 30251 Primary Status: Cancelled

Address :
9862 E MISSION GORGE RD, STE E
SANTEE CA 92071
SAN DIEGO COUNTY

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