Dental Board of California
Licensing details for: 10546
Name: LEXANN SMILE DENTAL PRACTICE OF HAI PHAN, DDS, INC.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PHAN, HAI THANH
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: PHAN, HAI THANH
License/Registration Type: Dentist License
License Number: 46671 Primary Status: Current - Active
Address :
824 Jana Ln
SAN JOSE CA 95111-1537
SANTA CLARA COUNTY
