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Licensing details for: 19034

Name: S.F. CHIDREN'S DENTAL DENTAL GROUP OF BAEK D.D.S. INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

1196 VALENCIA ST., STE. 106
SAN FRANCISCO CA 94100
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Practice Location

1196 VALENCIA ST., STE. 106
SAN FRANCISCO CA 94100
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Issuance Date

October 28, 2024

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:3:48 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: BAEK, JOSHUA S

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: BAEK, JOSHUA S

License/Registration Type: Dentist License

License Number: 103985 Primary Status: Current - Active

Address :
7604 Reseda Blvd
RESEDA CA 91335-2822
LOS ANGELES COUNTY

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