Provider Demographics
NPI:1972396794
Name:WRIGHT, CONNOR RICHARD
Entity type:Individual
Prefix:
First Name:CONNOR
Middle Name:RICHARD
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 UNIVERSITY VLG
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-3503
Mailing Address - Country:US
Mailing Address - Phone:801-425-3732
Mailing Address - Fax:
Practice Address - Street 1:168 W 800 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-1624
Practice Address - Country:US
Practice Address - Phone:801-374-8205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10155766-99261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice