Provider Demographics
NPI:1891110201
Name:MCINTYRE FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:MCINTYRE FAMILY DENTISTRY, PLLC
Other - Org Name:CLEAR SPRINGS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-268-4011
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-21
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27284122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty