Organization
THOMAS R. BACON, DDS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RAYMOND BACON DDS (PRESIDENT)
(603) 542-5197
Entity
Organization
Contact information
Practice address
200 BROAD STREET, CLAREMONT, NH 03743-1435
(603) 542-5197
(603) 542-3531
Mailing address
PO BOX 1435, 200 BROAD STREET, CLAREMONT, NH 03743-1435
(603) 542-5197
(603) 542-3531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1486
NH
Other
Enumeration date
06/12/2007
Last updated
08/22/2020
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