Dental Board of California
Licensing details for: 11151
Name: HUNTINGTON BEACH FAMILY DENTAL, OFFICE OF KIM T. PHAM, D.M.D. & M
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: HUNTINGTON BEACH FAMILY DENTAL
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: PHAM, KIM THU
License/Registration Type: Dentist License
License Number: 55500 Primary Status: Current - Active
Address :
1325 N Anaheim Blvd
ANAHEIM CA 92801-1202
ORANGE 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: SCAMURRA, MICHAEL JOHN
License/Registration Type: Dentist License
License Number: 55501 Primary Status: Current - Active
Address :
California Rehabilitation Cent
Dental Department
Fifth Street
NORCO CA 92860
RIVERSIDE COUNTY
