Provider Demographics
NPI:1558755876
Name:WRIGHT, PHILIP DANIEL (DMD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:DANIEL
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 1:701 EXPOSITION PL STE 210
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3359
Mailing Address - Country:US
Mailing Address - Phone:919-845-4955
Mailing Address - Fax:
Practice Address - Street 1:701 EXPOSITION PL STE 210
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3359
Practice Address - Country:US
Practice Address - Phone:919-845-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9785122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist