Provider Demographics
NPI:1396369542
Name:SIKORA, JESSICA M (DMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:SIKORA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:ME
Mailing Address - Zip Code:04344-1622
Mailing Address - Country:US
Mailing Address - Phone:207-626-3091
Mailing Address - Fax:
Practice Address - Street 1:14 MERRILL ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:ME
Practice Address - Zip Code:04344-1622
Practice Address - Country:US
Practice Address - Phone:207-626-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist