Dental Board of California
Licensing details for: 1173
Name: COSMOS DENTAL CENTER, SOO-DONG KIM, DDS DENTAL OFFICE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: COSMOS DENTAL CENTER, SO-DONG KIM, DDS DENTAL OFFICE
Address of Record
15206 PARTHENIA STREET
SEPULVEDA CA 91343
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KIM, SOO-DONG
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: KIM, SOO-DONG
License/Registration Type: Dentist License
License Number: 38859 Primary Status: Current - Active
Address :
5218 Imperial Pl
RANCHO CUCAMONGA CA 91739-8980
SAN BERNARDINO COUNTY
