Provider Demographics
NPI:1881849693
Name:BANCROFT, JOANNE (DDS)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:BANCROFT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 PLATTE ST APT 403
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6111
Mailing Address - Country:US
Mailing Address - Phone:716-940-8796
Mailing Address - Fax:
Practice Address - Street 1:1440 W 29TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2459
Practice Address - Country:US
Practice Address - Phone:970-622-0922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist