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Licensing details for: 79185

Name: SALEHPOUR AND PHAM DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1975 Garnet Ave
SUITE E
SAN DIEGO CA 92109-3594
SAN DIEGO county
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Practice Location

1975 Garnet Ave
SUITE E
SAN DIEGO CA 92109-3594
SAN DIEGO county
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Issuance Date

December 23, 2016

Expiration Date

April 30, 2019

Current Date / Time

June 6, 2025
2:22:15 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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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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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, MINH BAO

License/Registration Type: Dentist License

License Number: 46321 Primary Status: Expired

Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO COUNTY

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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: SALEHPOUR, MAYSAM MAGID

License/Registration Type: Dentist License

License Number: 61527 Primary Status: Current - Active

Address :
5153 JACKSON DRIVE
LA MESA CA 91942
SAN DIEGO COUNTY

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