Dental Board of California
Licensing details for: 10856
Name: TOWNGATE FAMILY DENTAL AND ORTHODONTICS, DENTAL PRACTICE OF SANG
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: TOWNGATE FAMILY DENTAL AND ORTHODONTICS DENTAL PRACTICE OF SAG G SHIN, DDS, INC.
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SHIN, SANG GYU
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: SHIN, SANG GYU
License/Registration Type: Dentist License
License Number: 59863 Primary Status: Current - Active
Address :
12625 Frederick St
Suite F-4
MORENO VALLEY CA 92553-5216
RIVERSIDE COUNTY
