Provider Demographics
NPI:1386920676
Name:WRIGHT CARE DENTISTRY
Entity type:Organization
Organization Name:WRIGHT CARE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEDNAM-WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-520-3263
Mailing Address - Street 1:7202 GILES RD STE 4-255
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-6000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 HERITAGE LNDG STE 210
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63303-8488
Practice Address - Country:US
Practice Address - Phone:636-447-2424
Practice Address - Fax:636-447-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental