Dental Board of California
Licensing details for: 17774
Name: SKY PEDIATRIC DENTISTRY DENTAL OFFICE OF DR. MICHAEL PARK
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PARK, MICHAEL H
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: PARK, MICHAEL H
License/Registration Type: Dentist License
License Number: 106120 Primary Status: Current - Active
Address :
1315 Manhattan Beach Blvd
Unit B
MANHATTAN BEACH CA 90266-5227
LOS ANGELES COUNTY
