Provider Demographics
NPI:1770841975
Name:SAM WRIGHT FAMILY DENTISTRY INC.
Entity Type:Organization
Organization Name:SAM WRIGHT FAMILY DENTISTRY INC.
Other - Org Name:HOWARD FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:501-847-1889
Mailing Address - Street 1:22450 INTERSTATE 30
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-2361
Mailing Address - Country:US
Mailing Address - Phone:501-847-1889
Mailing Address - Fax:
Practice Address - Street 1:22450 INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2361
Practice Address - Country:US
Practice Address - Phone:501-847-1889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3718261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental