Provider Demographics
NPI:1780798454
Name:WRIGHT, MICHAEL LEON (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEON
Last Name:WRIGHT
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 1:2501 CRESTWOOD RD STE 301
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7617
Mailing Address - Country:US
Mailing Address - Phone:501-758-1565
Mailing Address - Fax:501-758-1842
Practice Address - Street 1:2501 CRESTWOOD RD STE 301
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7617
Practice Address - Country:US
Practice Address - Phone:501-758-1565
Practice Address - Fax:501-758-1842
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR26201223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics