# L ALAN BACON DDS PC & JOHN COLLINS DDS PC

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

## Provider details

- **NPI number:** 1972504389
- **Authorized official:** MS. DONNA L FULLER (OFFICE MANAGER)
- **Authorized official phone:** (423) 224-3200

## Contact information

- **Practice address:** 117 W SEVIER AVE, SUITE 220, KINGSPORT, TN 37660-3799
- **Practice address phone:** (423) 224-3200
- **Practice address fax:** (423) 224-3208
- **Mailing address:** 117 W SEVIER AVE, SUITE 220, KINGSPORT, TN 37660-3799
- **Mailing address phone:** (423) 224-3200
- **Mailing address fax:** (423) 224-3208

## 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:** 08/09/2005
- **Last updated:** 03/01/2012