Individual
DR. PHILLIP GORDON MCINTOSH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3101 BRECKENRIDGE LANE, 1-E, LOUISVILLE, KY 40220
(502) 459-7352
(502) 459-7922
Mailing address
3101 BRECKENRIDGE LANE, 1-E, LOUISVILLE, KY 40220
(502) 459-7352
(502) 459-7922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5469
KY
1223G0001X
General Practice Dentistry
Primary
5469
KY
Other
Enumeration date
11/06/2006
Last updated
05/20/2024
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