Provider Demographics
NPI:1508305731
Name:WRIGHT, JOANNE EILEEN (LDA)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:EILEEN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 7TH ST E
Mailing Address - Street 2:#101
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-4914
Mailing Address - Country:US
Mailing Address - Phone:651-222-1201
Mailing Address - Fax:
Practice Address - Street 1:30 7TH ST E
Practice Address - Street 2:#101
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-4914
Practice Address - Country:US
Practice Address - Phone:651-222-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA573126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant