Provider Demographics
NPI:1275633935
Name:WRIGHT, WILLIAM L (D D S, M S)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:D D S, M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S BROWN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1428
Mailing Address - Country:US
Mailing Address - Phone:517-782-9331
Mailing Address - Fax:
Practice Address - Street 1:610 S BROWN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1428
Practice Address - Country:US
Practice Address - Phone:517-782-9331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010111611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics