Provider Demographics
NPI:1104089416
Name:LAFOND, TALIA VICTORIA WOOD (DMD)
Entity type:Individual
Prefix:DR
First Name:TALIA
Middle Name:VICTORIA WOOD
Last Name:LAFOND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TALIA
Other - Middle Name:VICTORIA
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1800 SULLIVAN TRL STE 120
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8397
Mailing Address - Country:US
Mailing Address - Phone:509-760-2347
Mailing Address - Fax:
Practice Address - Street 1:1800 SULLIVAN TRL STE 120
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8397
Practice Address - Country:US
Practice Address - Phone:509-760-2347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1858122300000X
PADS039081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist