Dental Board of California
Licensing details for: 4990
Name: MADISON SQUARE DENTISTRY, DENTAL PRACTICE OF DO DENTAL
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Address of Record
25092 MADISON AVE
MURRIETA CA 92562-8916
RIVERSIDE county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DO, THANG QUOC
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DO, THANG
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: DO, THANG QUOC
License/Registration Type: Dentist License
License Number: 46783 Primary Status: Current - Active
Address :
14782 Riata St
MIDWAY CITY CA 92655-1349
ORANGE COUNTY
