Organization
SIFFRARD FAMILY DENTISTRY, PLLC
Active
Other names
Dreamteam Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANITA ALEXANDER SIFFRARD D.D.S. (DENTIST/OWNER)
(662) 895-3000
Entity
Organization
Contact information
Practice address
6760 GOODMAN RD, OLIVE BRANCH, MS 38654
(662) 895-3000
(662) 895-3021
Mailing address
6760 GOODMAN RD, OLIVE BRANCH, MS 38654
(662) 895-3000
(662) 895-3021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
348908
MS
122300000X
Dentist
3686-13
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09523504
—
MS
05
—
09822823
—
MS
Enumeration date
10/22/2014
Last updated
10/22/2014
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