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Licensing details for: 17584

Name: TUSTIN COMMUNITY DENTISTRY DENTAL OFFICE OF DAVE NGUYEN, DMD, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

13400 NEWPORT AVEL #B
TUSTIN CA 92780
ORANGE county
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Practice Location

13400 NEWPORT AVEL #B
TUSTIN CA 92780
ORANGE county
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Issuance Date

December 28, 2022

Expiration Date

November 30, 2026

Current Date / Time

June 7, 2025
2:51:34 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, DAVE HOAIPHUONG

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: NGUYEN, DAVE HOAIPHUONG

License/Registration Type: Dentist License

License Number: 52761 Primary Status: Current - Active

Address :
13400 Newport Ave Ste B
TUSTIN CA 92780-3753
ORANGE COUNTY

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