MEDICARE: DR. HUGH EDWARD OGLETREE SR. DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3188	AL

General Provider Information

NPI Number	:	1831299403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUGH EDWARD OGLETREE SR. DMD

Provider Business Mailing Address
First Line	:	1010 4TH PL
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36869-6985
Country	:	US
Telephone Number	:	334-297-3277
Fax Number	:	334-297-3279

Provider Business Practice Location Address
First Line	:	1010 4TH PL
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36869-6985
Country	:	US
Telephone Number	:	334-297-3277
Fax Number	:	334-297-3279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	12/04/2012

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