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Individual
DR. TAVIS M SISSON
Active
Individual
DR. TAVIS M SISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
11507
TN
1223E0200X
Endodontics
Primary
DN20224
FL
1223G0001X
General Practice Dentistry
DGD.8284 GD
SC
1223G0001X
General Practice Dentistry
DN 20224
FL
Other
Enumeration date
07/02/2013
Last updated
04/12/2021
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