Provider Demographics
NPI:1922739176
Name:WAINWRIGHT, BRYCE BARCLAY (DMD)
Entity Type:Individual
Prefix:
First Name:BRYCE
Middle Name:BARCLAY
Last Name:WAINWRIGHT
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 1:3700 LEGACY DR APT 7207
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6634
Mailing Address - Country:US
Mailing Address - Phone:435-879-9635
Mailing Address - Fax:
Practice Address - Street 1:4851 LEGACY DR STE 201
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-0819
Practice Address - Country:US
Practice Address - Phone:972-335-9313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist