Individual
DR. JACK HAYNES HANCOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10 ENTERPRISE BLVD, SUITE 209, GREENVILLE, SC 29615-6301
(864) 234-8811
(864) 234-8844
Mailing address
10 ENTERPRISE BLVD, SUITE 209, GREENVILLE, SC 29615-6301
(864) 234-8811
(864) 234-8844
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1588
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z15889
—
SC
Enumeration date
09/15/2005
Last updated
07/08/2007
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