Dental Board of California
Licensing details for: 16078
Name: MAILEE MODERN DENTISTRY DENTAL PRACTICE OF DR. JENNIFER MAI & DR. ALEXANDER LEE
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: LEE, ALEXANDER
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: MAI, JENNIFER NA THI
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: LEE, ALEXANDER
License/Registration Type: Dentist License
License Number: 102433 Primary Status: Current - Active
Address :
15422 Crenshaw Blvd
GARDENA CA 90249-4524
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: MAI, JENNIFER NA THI
License/Registration Type: Dentist License
License Number: 103147 Primary Status: Current - Active
Address :
15422 Crenshaw Blvd
GARDENA CA 90249-4524
LOS ANGELES COUNTY
