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General NPI Number Information
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NPI Number | 1780769117
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Entity Type | Individual
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Provider Name | GARRY CRAIG WRIGHT DMD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 106A 16TH PL
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City | OPELIKA
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State | AL
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Zip | 36801-5634
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Country | US
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Telephone | 334-745-0119
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Fax | 334-745-0280
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Provider Business Mailing Address
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Address Line | 3839 COUNTY ROAD 31
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City | NOTASULGA
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State | AL
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Zip | 36866-3447
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Country | US
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Telephone | 334-257-1256
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Fax |
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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 | 3986
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License Number State | AL
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