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Licensing details for: 16616

Name: CENTER FOR BEAUTIFUL SMILES, DENTAL PRACTICE OF CHRISTOPHER PHAM DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1415 RIDGEBACK RD #23
CHULA VISTA CA 91910
SAN DIEGO county
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Practice Location

1415 RIDGEBACK RD #23
CHULA VISTA CA 91910
SAN DIEGO county
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Issuance Date

June 29, 2021

Expiration Date

March 31, 2022

Current Date / Time

December 14, 2025
6:19:23 AM

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: PHAM, CHRISTOPHER CUONG

License/Registration Type: Dentist License

License Number: 52915 Primary Status: Current - Active

Address :
9200 Scranton Rd
Ste 101
SAN DIEGO CA 92121-7716
SAN DIEGO COUNTY

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