Provider Demographics
NPI:1639287741
Name:GEORGE S PUGH DDS LTD
Entity Type:Organization
Organization Name:GEORGE S PUGH DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS LTD
Authorized Official - Phone:703-780-3300
Mailing Address - Street 1:8492 RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-8492
Mailing Address - Country:US
Mailing Address - Phone:703-780-3300
Mailing Address - Fax:703-780-3300
Practice Address - Street 1:8492 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-8492
Practice Address - Country:US
Practice Address - Phone:703-780-3300
Practice Address - Fax:703-780-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401003880122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty