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Licensing details for: 9842

Name: IRIS DENTAL OFFICE, ANH N TRAN DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: IRIS DENTAL

Address of Record

6965 BROADWAY
LEMON GROVE CA 91945
SAN DIEGO county
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Practice Location

6965 BROADWAY
LEMON GROVE CA 91945
SAN DIEGO county
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Issuance Date

March 20, 2012

Expiration Date

March 31, 2023

Current Date / Time

June 21, 2025
9:37:51 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: TRAN, ANH N

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: TRAN, ANH N

License/Registration Type: Dentist License

License Number: 54755 Primary Status: Current - Active

Address :
6965 BROADWAY
LEMON GROVE CA 91945
SAN DIEGO COUNTY

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