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Licensing details for: 15479

Name: SMILESPOT - PRACTICE OF DAVID PHAM DENTAL GROUP

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1000 E IMPERIAL HIGHWAY., SUITE A1
BREA CA 92821
ORANGE county
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Practice Location

1000 E IMPERIAL HIGHWAY., SUITE A1
BREA CA 92821
ORANGE county
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Issuance Date

November 21, 2019

Expiration Date

August 31, 2025

Current Date / Time

June 6, 2025
10:4:56 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PHAM, DAVID HUNG

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, DAVID HUNG

License/Registration Type: Dentist License

License Number: 48662 Primary Status: Current - Active

Address :
1000 E Imperial Hwy
SUITE A-1
BREA CA 92821-5602
ORANGE COUNTY

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