MEDICARE: DR. WILLIAM L. WRIGHT D. D. S., M. S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2901011161	MI

General Provider Information

NPI Number	:	1275633935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM L. WRIGHT D. D. S., M. S.

Provider Business Mailing Address
First Line	:	610 S BROWN ST
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-1428
Country	:	US
Telephone Number	:	517-782-9331
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 S BROWN ST
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-1428
Country	:	US
Telephone Number	:	517-782-9331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/08/2007

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