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Licensing details for: 81231

Name: CHRISTOPHER CUONG PHAM, DDS, A PROFESSIONAL DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

2987 CORONADO AVE STE A
SAN DIEGO CA 92154
SAN DIEGO county
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Practice Location

2987 CORONADO AVE STE A
SAN DIEGO CA 92154
SAN DIEGO county
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Issuance Date

June 8, 2022

Expiration Date

March 31, 2024

Current Date / Time

June 6, 2025
2:13:40 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: PHAM, CHRISTOPHER CUONG

License/Registration Type: Dentist License

License Number: 52915 Primary Status: Current - Active

Address :
9200 Scranton Rd
Ste 101
SAN DIEGO CA 92121-7716
SAN DIEGO COUNTY

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