Provider Demographics
NPI:1598191488
Name:MCANINCH, DAVID LEWIS IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEWIS
Last Name:MCANINCH
Suffix:IV
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1111 EAST OCEAN AVENUE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436
Mailing Address - Country:US
Mailing Address - Phone:805-735-3665
Mailing Address - Fax:805-735-5665
Practice Address - Street 1:1111 EAST OCEAN AVENUE
Practice Address - Street 2:SUITE 9
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436
Practice Address - Country:US
Practice Address - Phone:805-735-3665
Practice Address - Fax:805-735-5665
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2017-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA622041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery