Provider Demographics
NPI:1720207004
Name:WIGINTON, DENTON J
Entity Type:Individual
Prefix:
First Name:DENTON
Middle Name:J
Last Name:WIGINTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6833 COIT RD
Mailing Address - Street 2:STE107
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-5400
Mailing Address - Country:US
Mailing Address - Phone:972-491-2244
Mailing Address - Fax:
Practice Address - Street 1:6833 COIT RD
Practice Address - Street 2:STE107
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5400
Practice Address - Country:US
Practice Address - Phone:972-491-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist