Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 12449 | NC |
NPI | 1053804021 |
---|---|
Provider Name | Dr. Patrick William Mcintyre |
First Address | Gastonia, NC 28054-0632 |
Second Address | Gastonia, NC 28054-0632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2018 |
Last Update Date | 09/09/2021 |