Provider Demographics
NPI:1205984549
Name:WRIGHT, BENJAMIN D (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:D
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 1:406 DEERSPRING CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1773
Mailing Address - Country:US
Mailing Address - Phone:410-353-8706
Mailing Address - Fax:
Practice Address - Street 1:540 RITCHIE HWY
Practice Address - Street 2:STE. 301
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2998
Practice Address - Country:US
Practice Address - Phone:410-544-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics