Organization
GARY L. BACON D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L BACON DDS (OWNER)
(317) 897-1147
Entity
Organization
Contact information
Practice address
9670 E WASHINGTON ST STE 220, INDIANAPOLIS, IN 46229-3032
(317) 897-1147
(317) 897-1286
Mailing address
9670 E WASHINGTON ST STE 220, INDIANAPOLIS, IN 46229-3032
(317) 897-1147
(317) 897-1286
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/20/2008
Last updated
11/20/2008
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