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Licensing details for: 13326

Name: VALLEY DESERT DENTIST DENTAL OFFICE OF EUGENIE KIM

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Previous Names: VALLEY DESERT DENTIST

Address of Record

21580 BEAR VALLEY RD. #B2-2
APPLE VALLEY CA 92308
SAN BERNARDINO county
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Practice Location

21580 BEAR VALLEY RD #B2-2
APPLE VALLEY CA 92308
SAN BERNARDINO county
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Issuance Date

February 15, 2017

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
2:6:28 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KIM, EUGENIE HEO

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, EUGENIE HEO

License/Registration Type: Dentist License

License Number: 62603 Primary Status: Current - Active

Address :
62 SWIFT
IRVINE CA 92618-1705
ORANGE COUNTY

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