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Licensing details for: 15358

Name: SIERRA DENTAL HEALTH DENTAL GROUP OF HOA NGUYEN, DMD, INC.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

9190 SIERRA AVE STE 101
FONTANA CA 92335
SAN BERNARDINO county
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Practice Location

9190 SIERRA AVE STE 101
FONTANA CA 92335
SAN BERNARDINO county
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Issuance Date

September 23, 2019

Expiration Date

September 30, 2022

Current Date / Time

June 6, 2025
2:59:9 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, HOA NGOC

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: NGUYEN, HOA NGOC

License/Registration Type: Dentist License

License Number: 64645 Primary Status: Current - Active

Address :
28743 Valley Center Rd
A
VALLEY CENTER CA 92082-6530
SAN DIEGO COUNTY

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