Provider Demographics
NPI:1033466172
Name:MCINTYRE, ANN MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4213
Mailing Address - Country:US
Mailing Address - Phone:563-243-6950
Mailing Address - Fax:563-243-2648
Practice Address - Street 1:400 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4213
Practice Address - Country:US
Practice Address - Phone:563-243-6950
Practice Address - Fax:563-243-2648
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA089571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice