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Licensing details for: 12545

Name: APPLE TOOTH DENTAL GROUP SAMUEL H. KO, DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: APPLE TOOTH DENTAL GROUP

Address of Record

12429 MARIPOSA ROAD, SUITE A
VICTORVILLE CA 92395
SAN BERNARDINO county
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Issuance Date

December 17, 2015

Expiration Date

September 30, 2026

Current Date / Time

December 17, 2025
7:27:45 PM

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: KO, SAMUEL HYUNWOOK

License/Registration Type: Dentist License

License Number: 40454 Primary Status: Current - Active

Address :
12429 MARIPOSA RD. SUITE A
VICTORVILLE CA 92395
SAN BERNARDINO COUNTY

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