Dental Board of California
Licensing details for: 212
Name: YUAN, YI
License Type: Pediatric Minimal Sedation Permit
Primary Status: Current - Active
Practice Location
585 Saturn Blvd
Suite C
SAN DIEGO CA 92154-4721
SAN DIEGO county
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License Relationships
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: KIDZ SHINE DENTAL DENTAL OFFICE OF DR. YI YUAN
License/Registration Type: Fictitious Name Permit
License Number: 18787 Primary Status: Current - Active
Address :
585 SATURN BLVD, STE C
SAN DIEGO CA 92154
SAN DIEGO COUNTY
PMS to DDS or OMS or SP
License/Registration Role: Pediatric Minimal Sedation Permit
Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit
Name: YUAN, YI
License/Registration Type: Dentist License
License Number: 103040 Primary Status: Current - Active
Address :
585 Saturn Blvd
Suite C
SAN DIEGO CA 92154-4721
SAN DIEGO COUNTY
