Healthcare Provider Details

I. General information

NPI: 1477078954
Provider Name (Legal Business Name): WRIGHT AND ASSOCIATES VIII DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 PICCADILLY DR STE B
WINSTON SALEM NC
27104-3526
US

IV. Provider business mailing address

15 RAWLS RD STE 100
ANGIER NC
27501-6033
US

V. Phone/Fax

Practice location:
  • Phone: 336-837-3934
  • Fax: 336-518-0416
Mailing address:
  • Phone: 919-639-0264
  • Fax: 919-331-2415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: ALICIA M DUFFY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 919-295-2757