Individual
DR. MELVIN DAVID PEDERSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15121 E MISSISSIPPI AVE, AURORA, CO 80012-3746
(303) 802-1022
Mailing address
400 E MAIN ST STE 190, HILLSBORO, OR 97123-4163
(810) 287-5361
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00204856
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
D11868
OR
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00204856
CO
Other
Enumeration date
10/27/2021
Last updated
08/29/2023
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