Provider Demographics
NPI:1730101056
Name:PELPHREY, AL (DMD)
Entity Type:Individual
Prefix:DR
First Name:AL
Middle Name:
Last Name:PELPHREY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N MAYO TRL
Mailing Address - Street 2:SUITE #1
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1563
Mailing Address - Country:US
Mailing Address - Phone:606-437-1461
Mailing Address - Fax:
Practice Address - Street 1:300 N MAYO TRL
Practice Address - Street 2:SUITE #1
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1563
Practice Address - Country:US
Practice Address - Phone:606-437-1461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY62291223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry