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Licensing details for: 15440

Name: FOUNTAIN VALLEY DENTAL ESTHETICS, DENTAL OFFICE OF TOMMY C. LE DDS, A PROFESSIONAL DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

17900 BROOKHURST ST. STE. #A
FOUNTAIN VALLEY CA 92708
ORANGE county
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Practice Location

17900 BROOKHURST ST. STE. #A
FOUNTAIN VALLEY CA 92708
ORANGE county
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17900 Brookhurst St Ste A
Suite A
FOUNTAIN VALLEY CA 92708-5141
ORANGE county
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Issuance Date

November 4, 2019

Expiration Date

June 30, 2026

Current Date / Time

December 13, 2025
9:49:0 AM

License Relationships

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: LE, TOMMY CUONG

License/Registration Type: Dentist License

License Number: 57630 Primary Status: Current - Active

Address :
1641 E 17th St
Suite B
SANTA ANA CA 92705-8535
ORANGE COUNTY

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