Dental Board of California
Licensing details for: 12030
Name: TORREY PINES PEDIATRIC DENTISTRY, DENTAL PRACTICE OF CHIEU PHAM
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Address of Record
12395 EL CAMINO REAL, #312
SAN DIEGO CA 92130
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PHAM, CHIEU L
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: PHAM, CHIEU L
License/Registration Type: Dentist License
License Number: 52916 Primary Status: Current - Active
Address :
2015 Birch Rd Ste 103
CHULA VISTA CA 91915-2003
SAN DIEGO COUNTY
