Organization
HANCOCK DENTAL
Active
Parent organization
HANCOCK DENTAL
Other names
Hancock Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
HANCOCK DENTAL
Authorized official
DR. TAD E HANCOCK DDS (OWNER)
(208) 234-1006
Entity
Organization
Contact information
Practice address
485 W CHUBBUCK RD STE A, CHUBBUCK, ID 83202-2308
(208) 234-1006
(208) 234-8990
Mailing address
485 W CHUBBUCK RD STE A, CHUBBUCK, ID 83202-2308
(208) 234-1006
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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