Dental Board of California
Licensing details for: 81682
Name: KELLY KIM DENTAL CORPORATION
License Type: Additional Office Permit
Primary Status: Current - Active
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: WATANABE, BRYAN KAZUMI
License/Registration Type: Dentist License
License Number: 40130 Primary Status: Current - Active
Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE 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: LEE, FREDERICK HYUN WOO
License/Registration Type: Dentist License
License Number: 43359 Primary Status: Current - Active
Address :
4000 W. FLORIDA AVE.
HEMET CA 92545
RIVERSIDE 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: KIM, KELLY YEONSU
License/Registration Type: Dentist License
License Number: 58075 Primary Status: Current - Active
Address :
24088 CLINTON KEITH RD STE 100
WILDOMAR CA 92595
RIVERSIDE 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: ZAKLAMA, KARIM MAGID
License/Registration Type: Dentist License
License Number: 61349 Primary Status: Current - Active
Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES 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: DO YABUT, DIANA SONG
License/Registration Type: Dentist License
License Number: 53903 Primary Status: Current - Active
Address :
20201 CHIANTI COURT
YORBA LINDA CA 92886
ORANGE COUNTY



