Provider Demographics
NPI:1497965792
Name:WRIGHT, JAMES R (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 CALLIE WAY
Mailing Address - Street 2:P.O. BOX 130
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091
Mailing Address - Country:US
Mailing Address - Phone:859-384-1700
Mailing Address - Fax:859-384-2789
Practice Address - Street 1:2004 CALLIE WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-7521
Practice Address - Country:US
Practice Address - Phone:859-384-1700
Practice Address - Fax:859-384-2789
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY47711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice