Provider Demographics
NPI:1679531214
Name:WRIGHT, DAVID WAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
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 1:3615 W PARK ROW DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3027
Mailing Address - Country:US
Mailing Address - Phone:817-261-8414
Mailing Address - Fax:817-461-0600
Practice Address - Street 1:3615 W PARK ROW DRIVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-3027
Practice Address - Country:US
Practice Address - Phone:817-261-8414
Practice Address - Fax:817-461-0600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2618414ABOtherMPIN
81221727OtherTPIN
DN2163OtherLOGISTICS HEALTH INC