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Licensing details for: 4020

Name: HEALTHY SMILE DENTISTRY, DR PHUNG AND DR NGUYEN

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Partnership

Address of Record

1096 IRVINE BLVD
TUSTIN CA 92780
ORANGE county
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Issuance Date

December 18, 2002

Expiration Date

August 31, 2005

Current Date / Time

June 7, 2025
9:29:39 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, ANDREW TUAN

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: PHUNG, CHRISTINE THU

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: NGUYEN, ANDREW TUAN

License/Registration Type: Dentist License

License Number: 48521 Primary Status: Current - Active

Address :
4902 Irvine Center Dr
suite 101
IRVINE CA 92604-3305
ORANGE COUNTY

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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: PHUNG, CHRISTINE THU

License/Registration Type: Dentist License

License Number: 46931 Primary Status: Current - Active

Address :
4902 Irvine Center Dr Ste 1
IRVINE CA 92604-3305
ORANGE COUNTY

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