Provider Demographics
NPI:1003516790
Name:WRIGHT, SAMANTHA LEEANN
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LEEANN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:WORTHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76693-0041
Mailing Address - Country:US
Mailing Address - Phone:903-644-5353
Mailing Address - Fax:
Practice Address - Street 1:300 N SHERMAN ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2857
Practice Address - Country:US
Practice Address - Phone:254-562-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist