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Licensing details for: 82410

Name: BACH NGUYEN, DDS

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: San Pedro Smiles Dentistry, Inc.

Address of Record

29121 S. Western Avenue
RANCHO PALOS VERDES CA 90275
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Issuance Date

October 22, 2025

Expiration Date

August 31, 2026

Current Date / Time

December 13, 2025
3:37:3 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: NGUYEN, BACH XUAN

License/Registration Type: Dentist License

License Number: 49784 Primary Status: Current - Active

Address :
13528 Lakewood Blv
BELLFLOWER CA 90706

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