Provider Demographics
NPI:1508616293
Name:MCINTIRE, CALLIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CALLIE
Middle Name:
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:
Other - Last Name:ELGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1304 TIMOTHY DR
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2873
Mailing Address - Country:US
Mailing Address - Phone:731-445-5229
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 624
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7199
Practice Address - Country:US
Practice Address - Phone:501-686-8089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program