Provider Demographics
NPI:1902829740
Name:WRIGHT, J. DONOVAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:DONOVAN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 105
Mailing Address - Street 2:53 MAIN STREET
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858-0105
Mailing Address - Country:US
Mailing Address - Phone:908-439-2400
Mailing Address - Fax:908-439-2584
Practice Address - Street 1:53 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLDWICK
Practice Address - State:NJ
Practice Address - Zip Code:08858-0105
Practice Address - Country:US
Practice Address - Phone:908-439-2400
Practice Address - Fax:908-439-2584
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01243500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist