Dental Board of California
Licensing details for: 82916
Name: PETER PHAM, DDS
License Type: Additional Office Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: Lathrop Modern Dentistry, Prof. Corp.
Address of Record
16748 Golden Valley Parkway
LATHROP CA 95330
SAN JOAQUIN county
Map
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, PETER NGUYEN
License/Registration Type: Dentist License
License Number: 105741 Primary Status: Current - Active
Address :
16748 Golden Valley Pkwy
LATHROP CA 95330-7851
SAN JOAQUIN COUNTY
