Provider Demographics
NPI:1407935869
Name:A WRIGHT POND DDS LTD
Entity Type:Organization
Organization Name:A WRIGHT POND DDS LTD
Other - Org Name:SOUTHSIDE ORTHODONTICS LTD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHTON
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:POND
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-526-1241
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:250 E ELLERSLIE AVE
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-0697
Mailing Address - Country:US
Mailing Address - Phone:804-526-1241
Mailing Address - Fax:804-520-0546
Practice Address - Street 1:250 E ELLERSLIE AVE
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-0697
Practice Address - Country:US
Practice Address - Phone:804-526-1241
Practice Address - Fax:804-520-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4010040051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty