Dental Board of California
Licensing details for: 997
Name: DR. SONG BELGRAVE FAMILY DENTAL GROUP
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
Address of Record
6011 PACIFIC BLVD. STE 120
HUNTINGTON PARK CA 90255
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SONG, DAE HYUNG
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: SONG, DAE HYUNG
License/Registration Type: Dentist License
License Number: 25630 Primary Status: Current - Active
Address :
3129 N San Fernando Rd
LOS ANGELES CA 90065-1412
LOS ANGELES COUNTY
