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General NPI Number Information
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NPI Number | 1659948263
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Entity Type | Organization
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Legal Business Name | MCINTYRE FAMILY DENTAL, INC
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 291 N HUBBARDS LN STE 110
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City | LOUISVILLE
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State | KY
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Zip | 40207-8209
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Country | US
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Telephone | 502-897-6282
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Fax | 502-897-6286
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Provider Business Mailing Address
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Address Line | 291 N HUBBARDS LN STE 110
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City | LOUISVILLE
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State | KY
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Zip | 40207-8209
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Country | US
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Telephone | 502-897-6282
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Fax | 502-897-6286
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MARSHA MCINTYRE
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Credential | DMD
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Telephone | 502-897-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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