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Licensing details for: 8265

Name: REAGAN AND TIEU DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

709 CENTER DR, STE 101
SAN MARCOS CA 92069
SAN DIEGO county
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Issuance Date

May 17, 2004

Expiration Date

June 30, 2010

Current Date / Time

June 6, 2025
2:25:33 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: TIEU, ANDY LIANG

License/Registration Type: Dentist License

License Number: 49228 Primary Status: Current - Active

Address :
6790 TOP GUN ST. SUITE #5
SAN DIEGO CA 92121
SAN DIEGO COUNTY

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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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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