Provider Demographics
NPI:1306200639
Name:WRIGHT, ROBERT S (DDS, MS, MSED, FACP)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DDS, MS, MSED, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 13TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-7238
Mailing Address - Country:US
Mailing Address - Phone:805-226-9383
Mailing Address - Fax:
Practice Address - Street 1:522 13TH ST STE C
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-7238
Practice Address - Country:US
Practice Address - Phone:805-226-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455401223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics