Dental Board of California
Licensing details for: 11054
Name: PINE SMILES ORTHODONTICS AND PEDIATRIC DENTISTRY, DENTAL PRACTICE
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: PINE SMILES ORTHODONTICS AND REDIATRIC DENTISTRY PRACTICE OF KIM AND GANDHI KIM DENTAL CORPORATION
License Relationships
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: GANDHI KIM, AVANI D
License/Registration Type: Dentist License
License Number: 56935 Primary Status: Current - Active
Address :
5811 PINE AVE. SUITE B
CHINO HILLS CA 91709
SAN BERNARDINO 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: KIM, JIN YOUNG
License/Registration Type: Dentist License
License Number: 58103 Primary Status: Current - Active
Address :
5811 PINE AVE
Suite B
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
