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Individual

CRYSTAL L MCINTOSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS,MS

Contact information

Practice address
600 W ST NW, WASHINGTON DC, WASHINGTON, DC 20059-1022
(202) 806-0322
Mailing address
5304 ILLINOIS AVE NW, WASHINGTON, DC 20011-3906
(240) 508-9472

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
2901019380
MI
1223P0300X
Periodontics
Primary
DEN1000851
DC

Other

Enumeration date
05/18/2007
Last updated
03/04/2010
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