Provider Demographics
NPI:1477610970
Name:WRIGHT, DOUGLAS DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:DAVID
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 1:1710 BROADRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-9304
Mailing Address - Country:US
Mailing Address - Phone:540-432-6616
Mailing Address - Fax:540-432-6618
Practice Address - Street 1:1920 MEDICAL AVE STE F
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8016
Practice Address - Country:US
Practice Address - Phone:540-432-6616
Practice Address - Fax:540-432-6618
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist