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Licensing details for: 16261

Name: SCRIPPS POWAY DENTAL CARE, DENTAL PRACTICE OF ANDY L. TIEU DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

6790 TOP GUN ST, STE. 5
SAN DIEGO CA 92121
SAN DIEGO county
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Practice Location

6790 TOP GUN ST, STE. 5
SAN DIEGO CA 92121
SAN DIEGO county
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Issuance Date

February 1, 2021

Expiration Date

December 31, 2025

Current Date / Time

June 7, 2025
3:16:59 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: TIEU, ANDY LIANG

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: TIEU, ANDY LIANG

License/Registration Type: Dentist License

License Number: 49228 Primary Status: Current - Active

Address :
6790 TOP GUN ST. SUITE #5
SAN DIEGO CA 92121
SAN DIEGO COUNTY

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