Provider Demographics
NPI:1962631721
Name:LEWRIGHT, BRENT AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:AARON
Last Name:LEWRIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 SOUTHLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7561
Mailing Address - Country:US
Mailing Address - Phone:325-949-8535
Mailing Address - Fax:325-944-8908
Practice Address - Street 1:2520 SOUTHLAND BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-7561
Practice Address - Country:US
Practice Address - Phone:325-949-8535
Practice Address - Fax:325-944-8908
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN248091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice