Sjulson Family Dentistry
Organization Active NPI Dentist · Fosston, MN
NPI 1124386099 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1124386099
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 8437 (MN)
- Legal business name
- SJULSON FAMILY DENTISTRY
- Practice address
- 109 Johnson Ave. N
Fosston, MN 56542-1327 - Phone
- (218) 435-1599
- Fax
- (218) 435-6568
- NPI assigned
- Apr 30, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Roger Wayne Sjulson, D.D.S.
- Title
- Dentist
- Phone
- (218) 435-1599
Practitioners 2
-
Karissa Goetsch, DDS
-
Roger Wayne Sjulson, DDS
National Provider Directory
Locations
109 Johnson Ave N
Fosston, MN 56542
Phone (218) 435-1599
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 8437 | MN | Yes |
| Dentist |
122300000X | LGL5 | MN |
Addresses
Primary practice location
109 Johnson Ave. N
Fosston, MN 56542-1327
Mailing address
109 Johnson Ave N.
Fosston, MN 56542-1327
Phone (218) 435-1599
Other names
- Dr. Sjulson's Dental Office
Other providers in Fosston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.