Provider Demographics
NPI:1568640258
Name:MCINTYRE, GARLAN STEVE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARLAN
Middle Name:STEVE
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:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-0548
Mailing Address - Country:US
Mailing Address - Phone:229-423-4500
Mailing Address - Fax:229-423-3562
Practice Address - Street 1:112 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-2945
Practice Address - Country:US
Practice Address - Phone:229-423-4500
Practice Address - Fax:229-423-3562
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 73491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice