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Licensing details for: 79118

Name: TOMMY C LE DDS A PROFESSIONAL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

17900 Brookhurst St
STE A
FOUNTAIN VALLEY CA 92708-5141
ORANGE county
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Practice Location

17900 Brookhurst St
STE A
FOUNTAIN VALLEY CA 92708-5141
ORANGE county
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Issuance Date

October 21, 2016

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
3:42:18 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: LE, TOMMY CUONG

License/Registration Type: Dentist License

License Number: 57630 Primary Status: Current - Active

Address :
1641 E 17th St
Suite B
SANTA ANA CA 92705-8535
ORANGE COUNTY

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