Provider Demographics
NPI:1881851996
Name:PUGH, GEORGE TERRELL JR (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:TERRELL
Last Name:PUGH
Suffix:JR
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 1:26 WILSON AVE W
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-2022
Mailing Address - Country:US
Mailing Address - Phone:334-636-1133
Mailing Address - Fax:334-636-1131
Practice Address - Street 1:26 WILSON AVE W
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-2022
Practice Address - Country:US
Practice Address - Phone:334-636-1133
Practice Address - Fax:334-636-1131
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4459122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist