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General NPI Number Information
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NPI Number | 1548486558
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Entity Type | Organization
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Legal Business Name | WRIGHT FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1115 WINDOVER DRIVE
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City | JONESBORO
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State | AR
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Zip | 72401-6159
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Country | US
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Telephone | 870-932-2300
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Fax | 870-932-2302
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Provider Business Mailing Address
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Address Line | 1115 WINDOVER DRIVE
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City | JONESBORO
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State | AR
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Zip | 72401-6159
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Country | US
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Telephone | 870-932-2300
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Fax | 870-932-2302
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARSHA WRIGHT
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Credential |
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Telephone | 870-932-2300
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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 | 3296
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License Number State | TN
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