Individual
DR. JANE E BANCUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7184 MEADOWBROOK DR, CANTON, MI 48187-3552
(734) 844-8438
Mailing address
7184 MEADOWBROOK DR, CANTON, MI 48187-3552
(734) 844-8438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901013245
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264873
UNITED CONCORDIA INS
—
01
—
D132450
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
05/07/2007
Last updated
02/05/2015
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