Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 0163 | NC |
N | 1223D0001X | Dental Public Health | DN20692 | MA |
NPI | 1396117990 |
---|---|
Provider Name | Dr. Wanda Wright |
First Address | Greenville, NC 27834-5925 |
Second Address | Greenville, NC 27834-5925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 22/10/2015 |