Dental Board of California
Licensing details for: 4313
Name: SAN JACINTO DENTAL GROUP, PAIK & LEE, DDS, INC
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
166 E MAIN ST, STE 6
SAN JACINTO CA 92583
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PAIK, SANG CHURL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LEE, JASON SANG
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: LEE, JASON SANG
License/Registration Type: Dentist License
License Number: 47386 Primary Status: Current - Active
Address :
1183 E. FOOTHILL BLVD STE 240
UPLAND CA 91786
SAN BERNARDINO 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: PAIK, SANG CHURL
License/Registration Type: Dentist License
License Number: 41861 Primary Status: Current - Active
Address :
25920 IRIS AVE.
STE 14A
MORENO VALLEY CA 92551
RIVERSIDE COUNTY
