Individual
DR. JORDAN PELLEGROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
140 TWIN RIVERS CT, SARTELL, MN 56377-2015
(320) 257-3380
Mailing address
11757 E 25TH AVE UNIT 7208, AURORA, CO 80010-1297
(320) 223-4237
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D14853
MN
Other
Enumeration date
08/03/2022
Last updated
09/05/2023
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