Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32132 | CA |
NPI | 1205890167 |
---|---|
Provider Name | Dr. William Oliver Mcintire |
First Address | San Diego, CA 92128-2450 |
Second Address | San Diego, CA 92128-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2006 |
Last Update Date | 08/07/2007 |