# L ALAN BACON DDS PC & JOHN COLLINS DDS PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Associated Oral and Maxillofacial Surgeons
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518969229
- **Authorized official:** MS. DONNA L FULLER (OFFICE MANAGER)
- **Authorized official phone:** (423) 224-3200

## Contact information

- **Practice address:** 508 PRINCETON RD, SUITE 204, JOHNSON CITY, TN 37601-2060
- **Practice address phone:** (423) 915-1072
- **Practice address fax:** (423) 915-1075
- **Mailing address:** 508 PRINCETON RD, SUITE 204, JOHNSON CITY, TN 37601-2060
- **Mailing address phone:** (423) 915-1072
- **Mailing address fax:** (423) 915-1075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/12/2005
- **Last updated:** 03/01/2012