License Directory

Ethan Thien Ta

Active

California license 111703

License

Licensed by
Dental Board of California
License number
111703
Status
Active (Current)
First issued
June 17, 2025
Expires
May 31, 2027
License holder
Ethan Thien Ta
Entity type
Individual

Classifications

More from the license record

License type code
4401

Contact

4128 Rio Azul Way
Oceanside, CA 92057-3554
San Diego County