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Licensing details for: 10387

Name: PACIFIC HARBOR DENTAL GROUP AND ORTHODONTICS, NGUYEN AND REAGAN D

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3030 Harbor Blvd Ste G1
COSTA MESA CA 92626-2562
ORANGE county
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Practice Location

3030 HARBOR BOULEVARD, STE. G1
COSTA MESA CA 92626
ORANGE county
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Issuance Date

March 15, 2013

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:14:6 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name 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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