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Dr. Jordan Pellegrom, DDS
Pediatric Dentist in Sartell, Minnesota
NPI 1639806326

Jordan Pellegrom is a Pediatric Dentist based in Aurora, MN and is specialized in Pediatric Dentistry. Jordan Pellegrom practices in Sartell, MN and has the professional credentials of DDS. The NPI Number for Jordan Pellegrom is 1639806326 and holds a License No. D14853 (Minnesota).

The current practice location address for Jordan Pellegrom is 140 Twin Rivers Ct, Sartell, MN and can be reached out via phone at 320-257-3380.

Location: 140 Twin Rivers Ct, Sartell, MN, 80010-1297
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639806326
Provider Name
Jordan Pellegrom
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
140 Twin Rivers Ct, Sartell, MN, 80010-1297
Phone Number
320-257-3380
Fax Number
Provider Enumeration Date
08/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
140 Twin Rivers Ct
City
Sartell
State
Minnesota
Zip
56377-2015
Phone Number
320-257-3380
Fax Number
person
Provider Business Mailing Address Details
Address
140 Twin Rivers Ct
City
Sartell
State
Minnesota
Zip
56377-2015
Phone Number
320-257-3380
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
D14853 (Minnesota)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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