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Licensing details for: 14562

Name: SMILE DENTAL DENTAL OFFICE OF EUGENIE KIM

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

12190 PERRIS BLVD, STE D
MORENO VALLEY CA 92557
RIVERSIDE county
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Practice Location

12190 PERRIS BLVD, STE D
MORENO VALLEY CA 92557
RIVERSIDE county
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Issuance Date

November 8, 2018

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
2:2:25 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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