Provider Demographics
NPI:1205973914
Name:PUGH, WILLIAM HEWITT (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HEWITT
Last Name:PUGH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6010 DRAPER ST
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:14590-1107
Mailing Address - Country:US
Mailing Address - Phone:315-594-8611
Mailing Address - Fax:888-236-2889
Practice Address - Street 1:6010 DRAPER ST
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:NY
Practice Address - Zip Code:14590-1107
Practice Address - Country:US
Practice Address - Phone:315-594-8611
Practice Address - Fax:888-236-2889
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0426911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice