Pellegrom, Jordan
Pellegrom, Jordan is an individual health care provider with primary practice located at 140 Twin Rivers Ct , Sartell MN 56377-2015. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Pellegrom, Jordan can be contacted via phone (320) 257-3380.Contact Information
Primary practice address
140 Twin Rivers Ct
Sartell MN 56377-2015
Phone: (320) 257-3380
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | D14853 | Minnesota |
Profile Details
| NPI number | 1639806326 |
|---|---|
| LBN Legal business name | Pellegrom, Jordan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2022 |
| Last updated | Sep 5th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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