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General NPI Number Information
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NPI Number | 1053231027
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Entity Type | Organization
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Legal Business Name | AMY PUGH DMD LLC
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 5021 SW CLUBHOUSE RD
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City | CROOKED RIVER RANCH
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State | OR
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Zip | 97760-8021
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Country | US
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Telephone | 541-241-4621
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Fax |
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Provider Business Mailing Address
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Address Line | 5021 SW CLUBHOUSE RD
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City | CROOKED RIVER RANCH
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State | OR
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Zip | 97760-8021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | AMY PUGH
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Credential | DMD
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Telephone | 503-810-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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