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General NPI Number Information
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NPI Number | 1821449976
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Entity Type | Organization
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Legal Business Name | MELANIE PUGH DMD, P.A. - GP
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 8800 BERNWOOD PKWY STE 4
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-9527
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Country | US
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Telephone | 239-949-1805
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Fax | 239-949-1821
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Provider Business Mailing Address
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Address Line | 8800 BERNWOOD PKWY STE 4
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-9527
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Country | US
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Telephone | 239-949-1805
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Fax | 239-949-1821
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Authorized Official
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Title or Position | MANAGER
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Name | JODY PUGH
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Credential |
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Telephone | 239-949-1805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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