Bacon, Larry Alan

Bacon, Larry Alan is an individual health care provider with primary practice located at 117 W Sevier Ave Suite 220, Kingsport TN 37660-3799. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Bacon, Larry Alan can be contacted via phone (423) 224-3200.

Contact Information

Primary practice address
117 W Sevier Ave Suite 220 Kingsport TN 37660-3799
Phone: (423) 224-3200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS2171 Tennessee

Profile Details

NPI number 1295736304
LBN Legal business name Bacon, Larry Alan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Mar 1st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295736304 NPPES
Tennessee Other 1609878388 ORGANIZATION NPI
Tennessee Other 3726194 ORGANIZATION NPI
Tennessee Other 1518969229 ORGANIZATION NPI
Tennessee Other 1972504389 ORGANIZATION NPI

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