Kim Khue Thi Phung
ActiveCalifornia license 45756
License
- Licensed by
- Dental Board of California
- License number
- 45756
- Status
- Active (Current)
- First issued
- July 27, 1998
- Expires
- November 30, 2027
- License holder
- Kim Khue Thi Phung
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
7970 Prince Valle Street
Gilroy, CA 95020
Gilroy, CA 95020
Santa Clara County