Dental Board of California
Licensing details for: 17408
Name: 5D SMILES DENTAL PRACTICE OF HENRY QIU, DDS, INC.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: QIU, HENRY
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: QIU, HENRY
License/Registration Type: Dentist License
License Number: 104634 Primary Status: Current - Active
Address :
8500 Florence Ave
Unit 100
8500 Florence Ave, Unit 100
DOWNEY CA 90240-4054
LOS ANGELES COUNTY
