Provider Demographics
NPI:1689263568
Name:WRIGHT NAEGER DENTISTRY PPLC
Entity Type:Organization
Organization Name:WRIGHT NAEGER DENTISTRY PPLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:D'ETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALDROP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-776-4843
Mailing Address - Street 1:4528 MILLS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-1100
Mailing Address - Country:US
Mailing Address - Phone:979-776-4843
Mailing Address - Fax:979-776-5174
Practice Address - Street 1:4528 MILLS PARK CIR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-1100
Practice Address - Country:US
Practice Address - Phone:979-776-4843
Practice Address - Fax:979-776-5174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty