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Licensing details for: 11208

Name: PHAM AND SAMBANGI DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1573 S Harbor Blvd
FULLERTON CA 92832-3402
ORANGE county
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Practice Location

1573 S. HARBOR BLVD
FULLERTON CA 92832
ORANGE county
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Issuance Date

September 18, 2013

Expiration Date

June 30, 2020

Current Date / Time

December 17, 2025
8:26:11 PM

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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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