Provider Demographics
NPI:1770649725
Name:JOHN J HANCK DDS PC
Entity Type:Organization
Organization Name:JOHN J HANCK DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HANCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-484-4890
Mailing Address - Street 1:1136 E STUART STE 4 101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1173
Mailing Address - Country:US
Mailing Address - Phone:970-484-4890
Mailing Address - Fax:970-484-5160
Practice Address - Street 1:1136 E STUART STE 4 101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1173
Practice Address - Country:US
Practice Address - Phone:970-484-4890
Practice Address - Fax:970-484-5160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD100060122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty