Dental Board of California
Licensing details for: 12029
Name: 4S PEDIATRIC DENTISTRY, DENTAL PRACTICE OF PHAM AND MAUSETH DDS I
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
16918 DOVE CANYON ROAD #203
SAN DIEGO CA 92127
SAN DIEGO county
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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: MAUSETH, SPENCER EUGENE
License/Registration Type: Dentist License
License Number: 61986 Primary Status: Current - Active
Address :
16918 Dove Canyon Rd
#203
SAN DIEGO CA 92127-3445
SAN DIEGO COUNTY
