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General NPI Number Information
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NPI Number | 1922739176
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Entity Type | Individual
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Provider Name | BRYCE BARCLAY WAINWRIGHT DMD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/20/2022
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Provider Practice Location Address
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Address Line | 4851 LEGACY DR STE 201
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City | FRISCO
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State | TX
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Zip | 75034-0819
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Country | US
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Telephone | 972-335-9313
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 LEGACY DR APT 7207
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City | FRISCO
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State | TX
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Zip | 75034-6634
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Country | US
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Telephone | 435-879-9635
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 38551
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License Number State | TX
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