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General NPI Number Information
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NPI Number | 1962528448
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Entity Type | Organization
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Legal Business Name | DAVID MCCANN DDS INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 27702 CROWN VALLEY PKWY SUITE A2
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City | LADERA RANCH
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State | CA
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Zip | 92694
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Country | US
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Telephone | 949-365-1900
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Fax | 949-365-1909
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Provider Business Mailing Address
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Address Line | 27702 CROWN VALLEY PKWY SUITE A2
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City | LADERA RANCH
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State | CA
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Zip | 92694
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Country | US
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Telephone | 949-365-1900
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Fax | 949-365-1909
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Authorized Official
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Title or Position | DENTIST OWNER PRESIDENT
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Name | DAVID STANLEY MCCANN
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Credential | DDS
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Telephone | 949-365-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 036099
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License Number State | CA
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