Dental Board of California
Licensing details for: 17799
Name: IRVINE SMILE DENTISTRY DENTAL PRACTICE OF CHRISTINE THU PHUNG DMD 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: NGUYEN, ANDREW TUAN
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PHUNG, CHRISTINE THU
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: PHUNG, CHRISTINE THU
License/Registration Type: Dentist License
License Number: 46931 Primary Status: Current - Active
Address :
4902 Irvine Center Dr Ste 1
IRVINE CA 92604-3305
ORANGE 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: NGUYEN, ANDREW TUAN
License/Registration Type: Dentist License
License Number: 48521 Primary Status: Current - Active
Address :
4902 Irvine Center Dr
suite 101
IRVINE CA 92604-3305
ORANGE COUNTY
