Provider Demographics
NPI:1922727643
Name:MCCAFFERTY, DUSTIN SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:SCOTT
Last Name:MCCAFFERTY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 SANTA HELENA
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1640
Mailing Address - Country:US
Mailing Address - Phone:480-335-8477
Mailing Address - Fax:
Practice Address - Street 1:9530 CUYAMACA ST STE 101
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-2687
Practice Address - Country:US
Practice Address - Phone:619-573-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1078831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice