Individual
DR. JANE A BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
260 JACKSON MEADOWS DR, HERMITAGE, TN 37076-1425
(615) 872-7762
Mailing address
260 JACKSON MEADOWS DR, HERMITAGE, TN 37076-1425
(615) 872-7762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5016
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4029996
BLUE CROSS BLUE SHIELD TN
TN
01
—
62308
CIGNA PROVIDER NUMBER
TN
Enumeration date
08/31/2006
Last updated
07/08/2007
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