Provider Demographics
NPI:1376607887
Name:SISSON, JUNE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:A
Last Name:SISSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 E BRIGANTINE AVE
Mailing Address - Street 2:#38
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-3190
Mailing Address - Country:US
Mailing Address - Phone:215-802-3276
Mailing Address - Fax:
Practice Address - Street 1:413 E BRIGANTINE AVE
Practice Address - Street 2:#38
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-3190
Practice Address - Country:US
Practice Address - Phone:215-802-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA022878L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice