Bacon, Paul H

Bacon, Paul H is an individual health care provider with primary practice located at 33 Mouse Creek Rd Nw , Cleveland TN 37312-4840. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bacon, Paul H can be contacted via phone (423) 479-9395.

Contact Information

Primary practice address
33 Mouse Creek Rd Nw Cleveland TN 37312-4840
Phone: (423) 479-9395
Fax: (423) 479-8372
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X Tennessee

Profile Details

NPI number 1477538809
LBN Legal business name Bacon, Paul H
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Jul 8th, 2007 - about 18 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 1477538809 NPPES
Tennessee MEDICAID 6744

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