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Licensing details for: 5064

Name: NATIONAL DENTAL OFFICE, PHAM & CAO DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2407 ATLANTIC AVE
LONG BEACH CA 90806
LOS ANGELES county
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Issuance Date

July 16, 2004

Expiration Date

April 30, 2013

Current Date / Time

April 7, 2026
1:32:34 AM

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: PHAM, TAYLOR THANH

License/Registration Type: Dentist License

License Number: 43483 Primary Status: Current - Active

Address :
15310 Goldenwest St
WESTMINSTER CA 92683-6150
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: CAO, ANTHONY HUNG

License/Registration Type: Dentist License

License Number: 43909 Primary Status: Current - Active

Address :
2200 HARBOR BLVD STE B-230
COSTA MESA CA 92627
ORANGE COUNTY

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