Provider Demographics
NPI:1114133436
Name:WRIGHT, HENRY MACMILLAN JR
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:MACMILLAN
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 SPRINGBANK LN
Mailing Address - Street 2:SUITE H
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3346
Mailing Address - Country:US
Mailing Address - Phone:704-542-2202
Mailing Address - Fax:
Practice Address - Street 1:3121 SPRINGBANK LN
Practice Address - Street 2:SUITE H
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3346
Practice Address - Country:US
Practice Address - Phone:704-542-2202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics