Provider Demographics
NPI:1821272733
Name:MCINTYRE, RITA DACIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:DACIA
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 ELMIRA ROAD
Mailing Address - Street 2:#367
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687
Mailing Address - Country:US
Mailing Address - Phone:530-304-9054
Mailing Address - Fax:
Practice Address - Street 1:2100 PEABODY ROAD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95696-4000
Practice Address - Country:US
Practice Address - Phone:707-454-3264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293691223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health