Provider Demographics
NPI:1548873151
Name:TYLER R. HANCOCK, DMD, PLLC
Entity type:Organization
Organization Name:TYLER R. HANCOCK, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:R
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-749-2424
Mailing Address - Street 1:303 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4009
Mailing Address - Country:US
Mailing Address - Phone:603-749-2424
Mailing Address - Fax:
Practice Address - Street 1:303 LOCUST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4009
Practice Address - Country:US
Practice Address - Phone:603-749-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty