Healthcare Provider Details

I. General information

NPI: 1134868284
Provider Name (Legal Business Name): ROBERT C. SJURSEN JR. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 FIELDSTONE PKWY STE 400
FRANKLIN TN
37069-4366
US

IV. Provider business mailing address

2020 FIELDSTONE PKWY STE 400
FRANKLIN TN
37069-4366
US

V. Phone/Fax

Practice location:
  • Phone: 615-591-5995
  • Fax: 615-591-5994
Mailing address:
  • Phone: 615-591-5995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT SJURSEN JR.
Title or Position: OWNER/ DENTIST
Credential: DDS
Phone: 615-591-5995