Dental Board of California
Licensing details for: 14688
Name: OMNIA DENTAL CARE DENTAL OFFICE OF DRS. PRIYAWAT AND KIM
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Partnership
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: KIM, MARIA
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PRIYAWAT, RUPPORN
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: PRIYAWAT, RUPPORN
License/Registration Type: Dentist License
License Number: 61647 Primary Status: Current - Active
Address :
264 Desert Bloom
IRVINE CA 92618-8872
ORANGE 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: KIM, MARIA
License/Registration Type: Dentist License
License Number: 65123 Primary Status: Current - Active
Address :
15911 Pomona Rincon Rd
120
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
