Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 7410 | TN |
NPI | 1013931898 |
---|---|
Provider Name | Dr. Ronald Stevens Wright JR. |
First Address | Brentwood, TN 37027-4241 |
Second Address | Brentwood, TN 37027-4241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 10/01/2013 |