Provider Demographics
NPI:1134868284
Name:ROBERT C. SJURSEN JR. PLLC
Entity type:Organization
Organization Name:ROBERT C. SJURSEN JR. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SJURSEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-591-5995
Mailing Address - Street 1:2020 FIELDSTONE PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4366
Mailing Address - Country:US
Mailing Address - Phone:615-591-5995
Mailing Address - Fax:
Practice Address - Street 1:2020 FIELDSTONE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-4366
Practice Address - Country:US
Practice Address - Phone:615-591-5995
Practice Address - Fax:615-591-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty