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Individual
DAN EDWARD BACON
Active
Individual
DAN EDWARD BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD,LD
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002312
GA
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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