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General NPI Number Information
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NPI Number | 1801414834
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Entity Type | Individual
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Provider Name | ALEXIS FERRELL PUGH DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 5391 MAGNOLIA TRCE
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City | HOOVER
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State | AL
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Zip | 35244-4622
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Country | US
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Telephone | 205-628-9789
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 HARMON DR
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City | PELL CITY
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State | AL
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Zip | 35128-6713
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Country | US
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Telephone | 205-908-5884
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0006528-C1
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License Number State | AL
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