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General NPI Number Information
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NPI Number | 1477954980
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Entity Type | Organization
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Legal Business Name | KELLY A WRIGHT DMD AND ASSOCIATES PA
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 09/16/2014
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Provider Practice Location Address
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Address Line | 303 S WALTON DR
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City | BENSON
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State | NC
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Zip | 27504-9396
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Country | US
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Telephone | 919-894-1612
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Fax | 919-894-2556
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Provider Business Mailing Address
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Address Line | 303 S WALTON DR
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City | BENSON
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State | NC
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Zip | 27504-9396
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Country | US
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Telephone | 919-894-1612
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Fax | 919-894-2556
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR/V.P.
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Name | MR. DANIEL LEE WRIGHT JR.
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Credential |
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Telephone | 910-568-8292
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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 | 7496
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License Number State | NC
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