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General NPI Number Information
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NPI Number | 1063270494
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Entity Type | Organization
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Legal Business Name | DR. AUSTIN S WRIGHT LLC
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Dates
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Enumeration Date | 03/11/2024
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 1516 MAIN STREET
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City | FYFFE
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State | AL
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Zip | 35971
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Country | US
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Telephone | 256-623-2272
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Fax | 256-623-2274
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Provider Business Mailing Address
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Address Line | POB 128
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City | FYFFE
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State | AL
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Zip | 35971-0128
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Country | US
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Telephone | 256-623-2272
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Fax | 256-623-2274
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Authorized Official
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Title or Position | OWNER
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Name | AUSTIN SANDERS WRIGHT
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Credential | DMD
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Telephone | 256-623-2272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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