Provider Demographics
NPI:1215216197
Name:MCINTYRE, DAVID JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 KOHLERS XING STE 100
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2461
Mailing Address - Country:US
Mailing Address - Phone:512-268-4011
Mailing Address - Fax:512-268-0409
Practice Address - Street 1:115 KOHLERS XING STE 100
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2461
Practice Address - Country:US
Practice Address - Phone:512-268-4011
Practice Address - Fax:512-268-0409
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice