Organization
SISSON FAMILY DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A SISSON DDS (OWNER)
(765) 778-2700
Entity
Organization
Contact information
Practice address
7550 S STATE ROAD 67, PENDLETON, IN 46064-8961
(765) 778-2700
(765) 778-8600
Mailing address
7550 S STATE ROAD 67, PENDLETON, IN 46064-8961
(765) 778-2700
(765) 778-8600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200242770A
—
IN
Enumeration date
01/28/2019
Last updated
02/03/2020
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