MEDICARE: FREDERICK ROLAND SCHILLING DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D9274	MN
2	173F00000X	Sleep Specialist (PhD)

General Provider Information

NPI Number	:	1841517836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK ROLAND SCHILLING DDS

Provider Business Mailing Address
First Line	:	250, 2ND. AVE S.
Second Line	:	STE 250
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-2173
Country	:	US
Telephone Number	:	612-338-4122
Fax Number	:

Provider Business Practice Location Address
First Line	:	250, 2ND. AVE S.
Second Line	:	STE 250
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55401-2173
Country	:	US
Telephone Number	:	612-338-4122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2010
Last Update Date	:	09/30/2010

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