Provider Demographics
NPI:1700529336
Name:WRIGHT, DALLIN (DMD)
Entity Type:Individual
Prefix:
First Name:DALLIN
Middle Name:
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 1:275 S ASPEN ST STOP 89
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-9562
Mailing Address - Country:US
Mailing Address - Phone:720-847-4118
Mailing Address - Fax:
Practice Address - Street 1:275 S ASPEN ST STOP 89
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9562
Practice Address - Country:US
Practice Address - Phone:720-847-4118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR390200000X122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist