Dental Board of California
Licensing details for: 20314
Name: Long Beach Modern Dentistry, Dental Group of Long Beach Modern Dentistry, Inc.
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
4630 E Pacific Coast Hwy Unit 3
LONG BEACH CA 90804
Map
License Relationships
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: COWAN, JUSTIN
License/Registration Type: Dentist License
License Number: 107711 Primary Status: Current - Active
Address :
4630 E Pacific Coast Hwy
LONG BEACH CA 90804
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: OATES, CHRISTOPHER COLLINS
License/Registration Type: Dentist License
License Number: 58874 Primary Status: Current - Active
Address :
1559 Pacific Coast Hwy
Ste 101
HERMOSA BEACH CA 90254-3214
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: NGUYEN, BACH XUAN
License/Registration Type: Dentist License
License Number: 49784 Primary Status: Current - Active
Address :
13528 Lakewood Blv
BELLFLOWER CA 90706
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: PESSAH, ARIELLA H
License/Registration Type: Dentist License
License Number: 59607 Primary Status: Current - Active
Address :
12214 Lakewood Blvd
102
DOWNEY CA 90242-2662
LOS ANGELES COUNTY
