Provider Demographics
NPI:1194882894
Name:WRIGHT, CRAIG JACKSON (DDS)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:JACKSON
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 1:33490 OAK GLEN RD STE F
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2095
Mailing Address - Country:US
Mailing Address - Phone:909-790-9300
Mailing Address - Fax:909-797-2600
Practice Address - Street 1:33490 OAK GLEN RD STE F
Practice Address - Street 2:
Practice Address - City:YUCAIPA
Practice Address - State:CA
Practice Address - Zip Code:92399-2095
Practice Address - Country:US
Practice Address - Phone:909-790-9300
Practice Address - Fax:909-797-2600
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34016122300000X
UT145483-9922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist