Provider Demographics
NPI:1669992459
Name:POND, MARGARET GRAY (DMD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:GRAY
Last Name:POND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 19TH ST N APT 606
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-3231
Mailing Address - Country:US
Mailing Address - Phone:256-345-3798
Mailing Address - Fax:
Practice Address - Street 1:29984 STATE HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:LOCUST FORK
Practice Address - State:AL
Practice Address - Zip Code:35097-5878
Practice Address - Country:US
Practice Address - Phone:205-681-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL64291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice