Dental Board of California
Licensing details for: 17797
Name: BASELINE ORTHODONTICS AND ORAL SURGERY DENTAL PRACTICE OF DRS. RUNGCHARASSAENG AND LEE
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: RUNGCHARASSAENG, KITICHAI
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LEE, HOWARD
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: LEE, HOWARD
License/Registration Type: Dentist License
License Number: 56363 Primary Status: Current - Active
Address :
6330 E. SPRING STREET
LONG BEACH CA 90815
LOS ANGELES 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: RUNGCHARASSAENG, KITICHAI
License/Registration Type: Dentist License
License Number: 45002 Primary Status: Current - Active
Address :
13063 Helen Dr
REDLANDS CA 92373-7434
SAN BERNARDINO COUNTY
