Individual
BRANDON RAY WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
108 TYLER WAY, LOLO, MT 59847
(406) 273-0490
(406) 273-7969
Mailing address
313 RIVER DRIVE, LOLO, MT 59847
(406) 273-0490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2214
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032552
—
MT
01
—
0032994
CHIPS ST OF MT
MT
Enumeration date
12/26/2006
Last updated
07/08/2007
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