Individual
JEROME WAYNE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1515 E 25TH ST, C-153 HIBBING COMMUNITY COLLEGE, HIBBING, MN 55746-3354
(218) 263-2918
Mailing address
1515 E 25TH ST, ROOM C-153, HIBBING, MN 55746-3354
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8426
MN
Other
Enumeration date
10/10/2006
Last updated
08/20/2007
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