Individual
PETER ROLAND DEGALLIER
Active
Individual
PETER ROLAND DEGALLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTAL THERAPIST
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
Update your record
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