# SISCO FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SISCO FAMILY DENTISTRY
- **Other names:** Jamestown Family Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275960312
- **Legal business name:** SISCO FAMILY DENTISTRY
- **Authorized official:** TRAVIS W SISCO DDS (OWNER)
- **Authorized official phone:** (931) 879-9544

## Contact information

- **Practice address:** 240 CENTRAL AVE. WEST, JAMESTOWN, TN 38556-0884
- **Practice address phone:** (931) 879-9544
- **Practice address fax:** (931) 879-0844
- **Mailing address:** PO BOX 884, JAMESTOWN, TN 38556-0884
- **Mailing address phone:** (931) 879-9544
- **Mailing address fax:** (931) 879-0844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2013
- **Last updated:** 10/03/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1528728 | — | TN |