Provider Demographics
NPI:1851335236
Name:WRIGHT, ANGELA LYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LYN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:WRIGHT
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 2428
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2428
Mailing Address - Country:US
Mailing Address - Phone:256-858-6055
Mailing Address - Fax:256-858-6161
Practice Address - Street 1:4815 SPARKMAN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3948
Practice Address - Country:US
Practice Address - Phone:256-858-6055
Practice Address - Fax:256-858-6161
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL48941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009982550Medicaid