Healthcare Provider Details

I. General information

NPI: 1487403499
Provider Name (Legal Business Name): MATTHEW SCOTT WRIGHT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 EUBANK BLVD SE
ALBUQUERQUE NM
87123-3399
US

IV. Provider business mailing address

120 EUBANK BLVD SE
ALBUQUERQUE NM
87123-3399
US

V. Phone/Fax

Practice location:
  • Phone: 505-600-2000
  • Fax:
Mailing address:
  • Phone: 505-600-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDB-2024-0130
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: