| NPI | 1811204365 |
|---|---|
| Former Name | COLLISHA WRIGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 10444) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 055237-1) |
| Enumeration Date | 2010-09-04 |
| Last Update Date | 2015-04-15 |