Provider Demographics
NPI:1033880083
Name:WRIGHT, AMANDA E (CRDH)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:E
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:E
Other - Last Name:PANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRDH
Mailing Address - Street 1:12692 TAMIAMI TRL E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-8431
Mailing Address - Country:US
Mailing Address - Phone:239-417-6453
Mailing Address - Fax:239-775-6628
Practice Address - Street 1:12692 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-8431
Practice Address - Country:US
Practice Address - Phone:239-417-6453
Practice Address - Fax:239-775-6628
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24084124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist