# MCANINCH DENTAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528599305
- **Authorized official:** DR. DAVID LEWIS MCANINCH IV DDS (PRESIDENT)
- **Authorized official phone:** (805) 735-3665

## Contact information

- **Practice address:** 1111 EAST OCEAN AVENUE, SUITE 9, LOMPOC, CA 93436
- **Practice address phone:** (805) 735-3665
- **Practice address fax:** (805) 735-5665
- **Mailing address:** 1111 EAST OCEAN AVENUE, SUITE 9, LOMPOC, CA 93436
- **Mailing address phone:** (805) 735-3665
- **Mailing address fax:** (805) 735-5665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 62204 | CA | Yes |

## Other

- **Enumeration date:** 03/23/2017
- **Last updated:** 03/23/2017