Basic Information
Provider Information
NPI: 1811555295
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: ELIZABETH
MiddleName: DARE HINCKS
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2416 BROOKWOOD TRL
Address2:  
City: SANFORD
State: NC
PostalCode: 273308200
CountryCode: US
TelephoneNumber: 9197707403
FaxNumber:  
Practice Location
Address1: 2300 RAMSEY ST
Address2:  
City: FAYETTEVILLE
State: NC
PostalCode: 283013856
CountryCode: US
TelephoneNumber: 9108227030
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/31/2019
LastUpdateDate: 03/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X11401NCY Dental ProvidersDentist 

No ID Information.


Home