Provider Demographics
NPI:1730238197
Name:WRIGHT, MARVIN DEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:DEAN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N WEBB RD
Mailing Address - Street 2:BLDG 301
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206
Mailing Address - Country:US
Mailing Address - Phone:316-687-2110
Mailing Address - Fax:316-636-9539
Practice Address - Street 1:2020 N WEBB RD
Practice Address - Street 2:BLDG 301
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-687-2110
Practice Address - Fax:316-636-9539
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5290122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS116603OtherBLUE CROSS BLUE SHIELD