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General NPI Number Information
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NPI Number | 1659798155
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Entity Type | Organization
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Legal Business Name | DR. RONNIE HANCOCK FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 1302 RAGUET STREET
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City | NACOGDOCHES
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State | TX
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Zip | 75961
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Country | US
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Telephone | 936-564-7240
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Fax | 936-564-2731
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Provider Business Mailing Address
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Address Line | 1302 RAGUET STREET
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City | NACOGDOCHES
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State | TX
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Zip | 75961
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Country | US
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Telephone | 936-564-7240
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RONALD S. HANCOCK
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Credential | D.D.S.
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Telephone | 936-564-7240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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