Provider Demographics
NPI:1699928119
Name:DAVID L. WRIGHT DDS
Entity type:Organization
Organization Name:DAVID L. WRIGHT DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-962-6172
Mailing Address - Street 1:309 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3315
Mailing Address - Country:US
Mailing Address - Phone:509-962-6172
Mailing Address - Fax:509-962-3864
Practice Address - Street 1:309 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3315
Practice Address - Country:US
Practice Address - Phone:509-962-6172
Practice Address - Fax:509-962-3864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251030051121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5049101U722OtherDEPARTMENT OF SOCIAL AND HEALTH SERVICES