Dental Board of California
Licensing details for: 18787
Name: KIDZ SHINE DENTAL DENTAL OFFICE OF DR. YI YUAN
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: YUAN, YI
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: YUAN, YI
License/Registration Type: Dentist License
License Number: 103040 Primary Status: Current - Active
Address :
585 Saturn Blvd
Suite C
SAN DIEGO CA 92154-4721
SAN DIEGO COUNTY
