Dental Board of California
Licensing details for: 1041
Name: SOUTH VAN NESS DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Address of Record
CHARLES NIP DDS
240 SHOTWELL ST STE 230
SAN FRANCISCO CA 94110
SAN FRANCISCO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NIP, GREGORY CHARLES
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: FONG, CLARK LEONG
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: NIP, CHARLES C
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: NIP, CHARLES C
License/Registration Type: Dentist License
License Number: 20241 Primary Status: Current - Inactive
Address :
2243 VAN NESS AVENUE STE 202
SAN FRANCISCO CA 94109
SAN FRANCISCO COUNTY
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: NIP, GREGORY CHARLES
License/Registration Type: Dentist License
License Number: 40382 Primary Status: Current - Active
Address :
3749 NORIEGA
SAN FRANCISCO CA 94122
SAN FRANCISCO COUNTY
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: FONG, CLARK LEONG
License/Registration Type: Dentist License
License Number: 40351 Primary Status: Current - Active
Address :
401A N San Mateo Dr
SAN MATEO CA 94401-2417
SAN MATEO COUNTY
