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General NPI Number Information
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NPI Number | 1114943834
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Entity Type | Individual
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Provider Name | CARL ALFONSO WRIGHT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 06/26/2014
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Provider Practice Location Address
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Address Line | 9673 GRALLATORIAL CIR
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City | PENSACOLA
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State | FL
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Zip | 32507-7204
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Country | US
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Telephone | 850-497-0598
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Fax |
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Provider Business Mailing Address
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Address Line | 8390 N PALAFOX ST
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City | PENSACOLA
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State | FL
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Zip | 32534-3735
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Country | US
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Telephone | 850-494-7150
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Fax | 850-494-7151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 15082
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License Number State | FL
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