Individual
PETER ROLAND DEGALLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTAL THERAPIST
Contact information
Practice address
720 E HIGHWAY 61, WINONA, MN 55987-5300
(507) 452-9453
Mailing address
720 E HIGHWAY 61, WINONA, MN 55987-5300
(507) 452-9453
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT117
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497784342
NPI
MN
01
—
1801957758
NPI
MN
01
—
1992930556
NPI
MN
Enumeration date
11/13/2019
Last updated
11/13/2019
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