# MICHAEL G. MCMAHON PROFESSIONAL DENTAL CORPORATION

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

## Provider details

- **NPI number:** 1538686126
- **Authorized official:** MICHAEL GERALD MCMAHON (DENTIST/OWNER)
- **Authorized official phone:** (619) 223-7189

## Contact information

- **Practice address:** 3405 KENYON ST STE 510, SAN DIEGO, CA 92110-5008
- **Practice address phone:** (619) 233-7189
- **Mailing address:** 3405 KENYON ST STE 510, SAN DIEGO, CA 92110-5008
- **Mailing address phone:** (619) 233-7189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1800X | Corporate Health Clinic/Center | 34383 | CA | Yes |

## Other

- **Enumeration date:** 08/24/2017
- **Last updated:** 07/21/2022