Dental Board of California
Licensing details for: 16583
Name: PRIMERA DENTAL DENTAL GROUP OF SHIN & LEE DDS, INC
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: PRIMERA DENTAL, DENTAL GROUP OF SHIN & LEE DDS, INC
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: LEE, GUNDONG
License/Registration Type: Dentist License
License Number: 65092 Primary Status: Current - Active
Address :
1235 N HARBOR BLVD, STE 100
FULLERTON CA 92832
ORANGE COUNTY
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: SHIN, SANG GYU
License/Registration Type: Dentist License
License Number: 59863 Primary Status: Current - Active
Address :
12625 Frederick St
Suite F-4
MORENO VALLEY CA 92553-5216
RIVERSIDE COUNTY
