Organization
L ALAN BACON DDS PC & JOHN COLLINS DDS PC
Active
Organization
L ALAN BACON DDS PC & JOHN COLLINS DDS PC
Active
Other names
Associated Oral and Maxillofacial Surgeons
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA L FULLER (OFFICE MANAGER)
(423) 224-3200
Entity
Organization
Contact information
Practice address
508 PRINCETON RD, SUITE 204, JOHNSON CITY, TN 37601-2060
(423) 915-1072
(423) 915-1075
Mailing address
508 PRINCETON RD, SUITE 204, JOHNSON CITY, TN 37601-2060
(423) 915-1072
(423) 915-1075
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023019254
JOHN R COLLINS IND. NPI
TN
01
—
1154322451
MICHAEL L HAMLIN IND. NPI
TN
01
—
1295736304
L ALAN BACON IND NPI
TN
01
—
1295736569
CARL W EILERS, JR IND NPI
TN
Enumeration date
08/12/2005
Last updated
03/01/2012
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