Individual
DR. GARY LEE BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
316 WASHINGTON POINTE DRIVE, INDIANAPOLIS, IN 46229
(317) 897-1147
(317) 897-1286
Mailing address
316 WASHINGTON POINTE DRIVE, INDIANAPOLIS, IN 46229
(317) 897-1147
(317) 897-1286
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009447A
IN
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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