Dental Board of California
Licensing details for: 17802
Name: SPARK DENTAL PRACTICE OF CHRISTOPHER PHAM DENTAL CORPORATION
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: PHAM, CHRISTOPHER CUONG
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: PHAM, CHRISTOPHER CUONG
License/Registration Type: Dentist License
License Number: 52915 Primary Status: Current - Active
Address :
9200 Scranton Rd
Ste 101
SAN DIEGO CA 92121-7716
SAN DIEGO COUNTY
