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Organization
L ALAN BACON DDS PC & JOHN COLLINS DDS PC
Active
Organization
L ALAN BACON DDS PC & JOHN COLLINS DDS PC
Active
Other names
Associated Oral and Maxillofacial Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA L FULLER (OFFICE MANAGER)
(423) 224-3200
Entity
Organization
Contact information
Practice address
117 W SEVIER AVE, SUITE 220, KINGSPORT, TN 37660-3799
(423) 224-3200
(423) 224-3208
Mailing address
117 W SEVIER AVE, SUITE 220, KINGSPORT, TN 37660-3799
(423) 224-3200
(423) 224-3208
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/09/2005
Last updated
03/01/2012
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