Provider Demographics
NPI:1245634773
Name:WRIGHT, CHRISTOPHER
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 AIRLINE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-5874
Mailing Address - Country:US
Mailing Address - Phone:318-746-6923
Mailing Address - Fax:318-746-6924
Practice Address - Street 1:2300 AIRLINE DR STE 200
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-5874
Practice Address - Country:US
Practice Address - Phone:318-746-6923
Practice Address - Fax:318-746-6924
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist