Dental Board of California
Licensing details for: 15997
Name: CREATE SMILES DENTAL, DENTAL GROUP OF PHILIP CHANG, DDS DENTAL CORPORATION.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CHANG, PHILIP MINSUK
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: CHANG, PHILIP MINSUK
License/Registration Type: Dentist License
License Number: 51048 Primary Status: Current - Active
Address :
1611 Crenshaw Blvd
C
TORRANCE CA 90501-3123
LOS ANGELES COUNTY
