Dental Board of California
Licensing details for: 13146
Name: LA JOLLA VILLAGE SMILES DENTISTRY DENTAL GROUP ALVARADO AND PHAM DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
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: ALVARADO, STEVEN Christopher
License/Registration Type: Dentist License
License Number: 59267 Primary Status: Current - Active
Address :
4640 Cass St Unit 9720
SAN DIEGO CA 92109-2804
SAN DIEGO 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: RYGG, LANCE CHRISTIAN
License/Registration Type: Dentist License
License Number: 30251 Primary Status: Cancelled
Address :
9862 E MISSION GORGE RD, STE E
SANTEE CA 92071
SAN DIEGO 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: PHAM, MINH BAO
License/Registration Type: Dentist License
License Number: 46321 Primary Status: Current - Active
Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO 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: REAGAN, DARIN SCOTT
License/Registration Type: Dentist License
License Number: 34407 Primary Status: Current - Active
Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY
