Provider Demographics
NPI:1265724785
Name:LE, ALISON WRIGHT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:WRIGHT
Last Name:LE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:LAUREL
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 TRUCK HOUSE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2728
Mailing Address - Country:US
Mailing Address - Phone:410-647-4269
Mailing Address - Fax:
Practice Address - Street 1:22 TRUCK HOUSE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2728
Practice Address - Country:US
Practice Address - Phone:410-647-4269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice