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General NPI Number Information
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NPI Number | 1649126137
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Entity Type | Individual
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Provider Name | KYLE LALANNE MCINTIRE PROPHY TECH
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Gender | Male
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 2310 CRAVEN ST UNIT 3230
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City | SAN DIEGO
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State | CA
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Zip | 92136-5311
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Country | US
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Telephone | 513-604-7471
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 NORMAN SCOTT RD # B1808AR
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City | SAN DIEGO
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State | CA
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Zip | 92136-5311
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Country | US
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Telephone | 513-604-7471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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