Provider Demographics
NPI:1205890167
Name:MCINTIRE, WILLIAM OLIVER (DMD,MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:OLIVER
Last Name:MCINTIRE
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11777 BERNARDO PLAZA CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2450
Mailing Address - Country:US
Mailing Address - Phone:858-487-7766
Mailing Address - Fax:858-487-5539
Practice Address - Street 1:11777 BERNARDO PLAZA CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2405
Practice Address - Country:US
Practice Address - Phone:858-487-7766
Practice Address - Fax:858-487-5539
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA321321223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics