Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 50 054625 | NY |
NPI | 1710110515 |
---|---|
Provider Name | Dr. Leland James Pond JR. |
First Address | Pasadena, CA 91110-0698 |
Second Address | Scottsdale, AZ 85256-4019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2009 |
Last Update Date | 18/09/2020 |