Provider Demographics
NPI:1154310241
Name:SHELLEY ANN SIGUR DDS PC
Entity Type:Organization
Organization Name:SHELLEY ANN SIGUR DDS PC
Other - Org Name:DICKSON DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-446-7050
Mailing Address - Street 1:1926 HWY 46 S
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2754
Mailing Address - Country:US
Mailing Address - Phone:615-446-7050
Mailing Address - Fax:615-446-4699
Practice Address - Street 1:1926 HWY 46 S
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2754
Practice Address - Country:US
Practice Address - Phone:615-446-7050
Practice Address - Fax:615-446-4699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS69641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0194337OtherBLUE CROSS BLUE SHIELD