| Sisco Family Dentistry | |
|
240 Central Ave. West Jamestown TN 38556-0884 | |
| (931) 879-9544 | |
| (931) 879-0844 |
| Full Name | Sisco Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 240 Central Ave. West, Jamestown, Tennessee |
| Authorized Official Name and Position | Travis W Sisco (OWNER) |
| Authorized Official Contact | 9318799544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sisco Family Dentistry Po Box 884 Jamestown TN 38556-0884 Ph: (931) 879-9544 | Sisco Family Dentistry 240 Central Ave. West Jamestown TN 38556-0884 Ph: (931) 879-9544 |
| NPI Number | 1275960312 |
|---|---|
| Provider Enumeration Date | 10/03/2013 |
| Last Update Date | 10/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275960312 | NPI | - | NPPES |
| 1528728 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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