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Licensing details for: 81133

Name: CHIEU PHAM DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2015 BIRCH RD UNIT 103
CHULA VISTA CA 91915
SAN DIEGO county
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Practice Location

2015 BIRCH RD UNIT 103
CHULA VISTA CA 91915
SAN DIEGO county
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Issuance Date

January 27, 2022

Expiration Date

August 31, 2025

Current Date / Time

June 7, 2025
4:40:59 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: 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

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