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Organization

SISCO FAMILY DENTISTRY

Active
Parent organization
SISCO FAMILY DENTISTRY
Other names
Jamestown Family Dentistry
Organization subpart
Yes

Provider details

NPI number
Legal business name
SISCO FAMILY DENTISTRY
Authorized official
TRAVIS W SISCO DDS (OWNER)
(931) 879-9544
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528728
TN
Enumeration date
10/03/2013
Last updated
10/03/2013
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