Provider Demographics
NPI:1730279662
Name:WRIGHT, DONALD GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GREGORY
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:D
Other - Middle Name:GREGORY
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4736 STARKEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8508
Mailing Address - Country:US
Mailing Address - Phone:540-989-4698
Mailing Address - Fax:540-989-4627
Practice Address - Street 1:4736 STARKEY RD STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8508
Practice Address - Country:US
Practice Address - Phone:540-989-4698
Practice Address - Fax:540-989-4627
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice