Dental Board of California
Licensing details for: 7472
Name: SAN GABRIEL DENTAL GROUP, CHAN & CHAN, DDS, INC.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Previous Names: SAN GABRIEL GROUP DENTAL OFFICE OF WAYMAN CHANN DDS AND KENNETH CHAN DDS ❖ SAN GABRIEL GROUP DENTAL OFFICE OF CHAN & CHAN, DDS, INC.
Address of Record
6909 N. ROSEMEAD BLVD.
SAN GABRIEL CA 91775
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: CHAN, KENNETH KA-TAT
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: CHAN, KENNETH KA-TAT
License/Registration Type: Dentist License
License Number: 47857 Primary Status: Current - Active
Address :
1315 Fair Oaks Ave
103
SOUTH PASADENA CA 91030
