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Dr. Jonathan Patrick Bacon, DDS
Pediatric Dentist in Baltimore, Maryland
NPI 1811336142

Jonathan Patrick Bacon is a Pediatric Dentist based in Upper Marlboro, MD and is specialized in Pediatric Dentistry. Jonathan Patrick Bacon practices in Baltimore, MD and has the professional credentials of DDS. The NPI Number for Jonathan Patrick Bacon is 1811336142 and holds a License No. 15309 (Maryland).

The current practice location address for Jonathan Patrick Bacon is 2700 Quarry Lake Dr Ste 190, Baltimore, MD and can be reached out via phone at 410-484-4401.

Location: 2700 Quarry Lake Dr Ste 190, Baltimore, MD, 20774-5338
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811336142
Provider Name
Jonathan Patrick Bacon
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2700 Quarry Lake Dr Ste 190, Baltimore, MD, 20774-5338
Phone Number
410-484-4401
Fax Number
Provider Enumeration Date
06/20/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2700 Quarry Lake Dr Ste 190
City
Baltimore
State
Maryland
Zip
21209-3743
Phone Number
410-484-4401
Fax Number
person
Provider Business Mailing Address Details
Address
2700 Quarry Lake Dr Ste 190
City
Baltimore
State
Maryland
Zip
21209-3743
Phone Number
410-484-4401
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Dentist Anesthesiologist
Taxonomy
1223D0004X
License No.
15309 (Maryland)
Definition
A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
15309 (Maryland)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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