Provider Demographics
NPI:1598296261
Name:WRIGHT, LYDIA COMBS (DMD)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:COMBS
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WESTMORELAND ST
Mailing Address - Street 2:
Mailing Address - City:HARROGATE
Mailing Address - State:TN
Mailing Address - Zip Code:37752-8200
Mailing Address - Country:US
Mailing Address - Phone:423-869-4762
Mailing Address - Fax:
Practice Address - Street 1:124 WESTMORELAND ST
Practice Address - Street 2:
Practice Address - City:HARROGATE
Practice Address - State:TN
Practice Address - Zip Code:37752-8200
Practice Address - Country:US
Practice Address - Phone:423-869-4762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91081223G0001X
TN116711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice