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PAMELA M BACON — OIG Excluded Provider (SPADALIA, MO, 1128b14)

PAMELA M BACON — OIG Excluded Provider (SPADALIA, MO, 1128b14) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: PAMELA M BACON; Type: Individual; Provider category: DENTAL PRACTICE.

NamePAMELA M BACON
TypeIndividual
Provider categoryDENTAL PRACTICE
SpecialtyDENTIST
NPI1275593618
CitySPADALIA
StateMO
ZIP65301
Exclusion authority1128b14
Exclusion reasonDefault on health education loan or scholarship obligations
Exclusion date1993-11-21
SourceHHS-OIG LEIE

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