Dental Board of California
Licensing details for: 7060
Name: MISSION BAY FAMILY DENTISTRY, DENTAL PRACTICE OF KWANG S. PARK,
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
3023 BUNKER HILL STREET, STE. 101
SAN DIEGO CA 92109
SAN DIEGO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: PARK, KWANG SEO
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: PARK, KWANG SEO
License/Registration Type: Dentist License
License Number: 49384 Primary Status: Current - Active
Address :
3023 Bunker Hill St Ste 101
SAN DIEGO CA 92109-5706
SAN DIEGO COUNTY
