{
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"OrgName": "MELANIE PUGH DMD, P.A. - GP",
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"FirstLineMailingAddress": "8800 BERNWOOD PKWY",
"SecondLineMailingAddress": "STE 4",
"MailingAddressCityName": "BONITA SPRINGS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34135-9527",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-949-1805",
"MailingAddressFaxNumber": "239-949-1821",
"FirstLinePracticeLocationAddress": "8800 BERNWOOD PKWY",
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"EnumerationDate": "06/29/2016",
"LastUpdateDate": "06/29/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PUGH",
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"AuthorizedOfficialTitle": "MANAGER",
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"AuthorizedOfficialTelephoneNumber": "239-949-1805",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}