Roger Wayne Sjulson, DDS
Individual provider Active NPI General Practice Dentistry · Fosston, MN
NPI 1720140841 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720140841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 8437 (MN)
- Practice address
- 109 Johnson Ave N
Fosston, MN 56542-1327 - Phone
- (218) 435-1599
- Fax
- (218) 435-6568
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8437 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sjulson Family Dentistry | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8437 | MN | Yes |
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 providers in Fosston, MN
- Todd William Sandwick
- Sanford Health of Northern Minnesota
- Sanford Health of Northern Minnesota
- Mei Wen W Sather
- Sjulson Family Dentistry
- Abigail Kraemer Spiering
- St Mary'S Regional Health Center
- Katelyn Stasney
- Darren D Swanson
- Sheila K Teiken
All providers in Fosston, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.