Provider Demographics
NPI:1366463408
Name:WRIGHT-PERRY, SECUNDA TAMARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SECUNDA
Middle Name:TAMARA
Last Name:WRIGHT-PERRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 ATOM ROAD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2902
Mailing Address - Country:US
Mailing Address - Phone:301-806-2155
Mailing Address - Fax:240-244-2187
Practice Address - Street 1:9507 ATOM ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2902
Practice Address - Country:US
Practice Address - Phone:301-806-2155
Practice Address - Fax:240-244-2187
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8953122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1366463408Medicaid