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General NPI Number Information
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NPI Number | 1740354364
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Entity Type | Individual
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Provider Name | MARSHA G MCINTYRE DMD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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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 |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7865
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License Number State | KY
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