Dr. Glen C Mcintosh
Oral and Maxillofacial Pathology
3400 Mcclure Bridge Rd Building G, Suite B
Duluth
, Georgia 30096-6675
Dr. Glen C Mcintosh
Oral and Maxillofacial Pathology
3400 Mcclure Bridge Rd Building G, Suite B
Duluth
, Georgia 30096-6675
(770) 623-9714
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Glen C Mcintosh
- 3400 Mcclure Bridge Rd Building G, Suite B
- Duluth, GA
- Zip : 30096-6675
- Fax : (770) 623-9714
- Phone : (770) 476-8576
Second Address
- Dr. Glen C Mcintosh
- 3400 Mcclure Bridge Rd Building G, Suite B
- Duluth, GA
- Zip : 30096-6675
- Fax : (770) 623-9714
- Phone : (770) 476-8576
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | DN009756 | GA |
National Provider Identifier
| NPI | 1285793372 |
|---|---|
| Provider Name | Dr. Glen C Mcintosh |
| First Address | Duluth, GA 30096-6675 |
| Second Address | Duluth, GA 30096-6675 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U16496 | (02) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.