Healthcare Provider Details

I. General information

NPI: 1093571846
Provider Name (Legal Business Name): WRIGHT DENTISTRY LLC, DBA SMILE DESIGN STUDIO OF MONTGOMERY VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19620A CLUB HOUSE RD
MONTGOMERY VILLAGE MD
20886-3003
US

IV. Provider business mailing address

19620A CLUB HOUSE RD
MONTGOMERY VILLAGE MD
20886-3003
US

V. Phone/Fax

Practice location:
  • Phone: 301-926-1900
  • Fax:
Mailing address:
  • Phone: 301-926-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TREVA WRIGHT
Title or Position: OWNER
Credential: DDS
Phone: 410-913-1077