Provider Demographics
NPI:1114092350
Name:WRIGHT, JOEL JESSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:JESSE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DDS
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 369
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-0369
Mailing Address - Country:US
Mailing Address - Phone:515-465-3501
Mailing Address - Fax:515-465-9390
Practice Address - Street 1:1305 2ND ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220-1511
Practice Address - Country:US
Practice Address - Phone:515-465-3501
Practice Address - Fax:515-465-9390
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA74381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice