Dental Board of California
Licensing details for: 79891
Name: SAN ELIJO DENTISTRY, DENTAL PRACTICE OF PHAM AND MAUSETH DDS INC.
License Type: Additional Office Permit
Primary Status: Cancelled
Organization Classification: Corporation
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: MAUSETH, SPENCER EUGENE
License/Registration Type: Dentist License
License Number: 61986 Primary Status: Current - Active
Address :
16918 Dove Canyon Rd
#203
SAN DIEGO CA 92127-3445
SAN DIEGO COUNTY
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
