Provider Demographics
NPI:1871611996
Name:MCINTYRE, FREDERICK MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:MICHAEL
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1465
Mailing Address - Country:US
Mailing Address - Phone:716-481-2560
Mailing Address - Fax:716-829-2440
Practice Address - Street 1:210A SQUIRE HALL UNIVERSITY DENTAL ASSOCIATES
Practice Address - Street 2:UB SCHOOL OF DENTAL MEDICINE
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-829-2862
Practice Address - Fax:716-829-2440
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0298041223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics