Dental Board of California
Licensing details for: 3994
Name: MILLBRAE DENTAL CENTER, DENTAL PRACTICE OF
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Previous Names: MILLBRAE DENTAL CARE, DENTAL PRACTICE OF
Address of Record
15 EL CAMINO REAL
MILLBRAE CA 94030
SAN MATEO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: YOON, ANNA
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: YOON, ANNA
License/Registration Type: Dentist License
License Number: 45218 Primary Status: Cancelled
Address Not Disclosed
