Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 6480 | NC |
NPI | 1114133436 |
---|---|
Provider Name | Mr. Henry Macmillan Wright JR. |
First Address | Charlotte, NC 28226-3346 |
Second Address | Charlotte, NC 28226-3346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |