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Contact Information

PAUL H BACON JR, DDS
33 MOUSE CREEK RD NW
CLEVELAND, TN37312-4840
 Phone: 423-479-9395
 Fax: 423-479-8372
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for PAUL H BACON JR · (Male)

NPI # 1477538809
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/08/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • TN Medicaid 6744
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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