Dental Board of California
Licensing details for: 16236
Name: MAC DENTAL GROUP OF UNION, RONALD CHONG KIM DDS, INC
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
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: KIM, RONALD CHONG WU
License/Registration Type: Dentist License
License Number: 47108 Primary Status: Current - Active
Address :
1014 N. Vermont Ave
LOS ANGELES CA 90029
LOS ANGELES COUNTY
