Dental Board of California
Licensing details for: 6404
Name: HEALTHY SMILE DENTISTRY, DR. ANDREW T. NGUYEN, DR. LONG N. PHAN &
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Partnership
Previous Names: HEALTHY SMILE DENTISTRY
Address of Record
30141 ANTELOPE RD., STE. G
MENIFEE CA 92584
RIVERSIDE county
Map
License Relationships
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: 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
