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Licensing details for: 15109

Name: VILLAGE DENTAL GROUP SONAL SINGH, D.D.S., INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

878 EASTLAKE PARKWAY, SUITE 1511
CHULA VISTA CA 91914
SAN DIEGO county
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Practice Location

878 EASTLAKE PARKWAY, SUITE 1511
CHULA VISTA CA 91914
SAN DIEGO county
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Issuance Date

July 9, 2019

Expiration Date

April 30, 2027

Current Date / Time

June 6, 2025
10:1:13 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PHAM, MINH BAO

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: PHAM, MINH BAO

License/Registration Type: Dentist License

License Number: 46321 Primary Status: Expired

Address :
5675 Balboa Ave
SAN DIEGO CA 92111-2705
SAN DIEGO COUNTY

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