Individual
DR. TROY BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
7275 SW DARTMOUTH ST, STE 180, TIGARD, OR 97223-8292
(503) 620-2319
Mailing address
7610 N. AUDUBON, SPOKANE, WA 99208
(509) 290-0960
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D10295
OR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE60576800
WA
Other
Enumeration date
01/25/2012
Last updated
07/29/2015
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