Provider Demographics
NPI:1275648651
Name:WRIGHT, BRUCE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
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 1:2211 AIRLINE DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5505
Mailing Address - Country:US
Mailing Address - Phone:281-992-2655
Mailing Address - Fax:409-945-6858
Practice Address - Street 1:1030 14TH ST N
Practice Address - Street 2:2750 WEST MAIN SUITE D
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5412
Practice Address - Country:US
Practice Address - Phone:409-945-7011
Practice Address - Fax:409-945-9858
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX182041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice