Healthcare Provider Details

I. General information

NPI: 1356822498
Provider Name (Legal Business Name): CIVIC CENTER DENTAL PARTNERS WRIGHT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E LAKE MEAD BLVD
NORTH LAS VEGAS NV
89030-6464
US

IV. Provider business mailing address

3030 N CENTRAL AVE STE 1500
PHOENIX AZ
85012-2750
US

V. Phone/Fax

Practice location:
  • Phone: 702-359-0847
  • Fax:
Mailing address:
  • Phone: 480-339-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. WHITNEY BOYLE WRIGHT
Title or Position: OFFICER
Credential: DDS
Phone: 480-339-4800