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Dr. Larry Alan Bacon, DDS
Oral and Maxillofacial Surgery (Dentist) in Kingsport, Tennessee
NPI 1295736304

Larry Alan Bacon is a Oral and Maxillofacial Surgery (Dentist) based in Kingsport, TN and is specialized in Oral and Maxillofacial Surgery. Larry Alan Bacon practices in Kingsport, TN and has the professional credentials of DDS. The NPI Number for Larry Alan Bacon is 1295736304 and holds a License No. DS2171 (Tennessee).

The current practice location address for Larry Alan Bacon is 117 W Sevier Ave, Kingsport, TN and can be reached out via phone at 423-224-3200.

Location: 117 W Sevier Ave, Kingsport, TN, 37660-3799
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Provider Profile Details
NPI Number
1295736304
Provider Name
Larry Alan Bacon
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
117 W Sevier Ave, Kingsport, TN, 37660-3799
Phone Number
423-224-3200
Fax Number
Provider Enumeration Date
08/10/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1609878388 01 TN ORGANIZATION NPI
3726194 01 TN MEDICARE GROUP NUMBER
1518969229 01 TN ORGANIZATION NPI
1972504389 01 ORGANIZATION NPI
institution
Provider Business Practice Location Address Details
Address
117 W Sevier Ave
City
State
Zip
37660-3799
Phone Number
423-224-3200
Fax Number
person
Provider Business Mailing Address Details
Address
117 W Sevier Ave
City
State
Zip
37660-3799
Phone Number
423-224-3200
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
License No.
DS2171 (Tennessee)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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