Provider Demographics
NPI:1659948263
Name:MCINTYRE FAMILY DENTAL, INC
Entity Type:Organization
Organization Name:MCINTYRE FAMILY DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-897-6282
Mailing Address - Street 1:291 N HUBBARDS LN STE 110
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-8209
Mailing Address - Country:US
Mailing Address - Phone:502-897-6282
Mailing Address - Fax:502-897-6286
Practice Address - Street 1:291 N HUBBARDS LN STE 110
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-8209
Practice Address - Country:US
Practice Address - Phone:502-897-6282
Practice Address - Fax:502-897-6286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental