NPI 1124663109

Peter Roland Degallier, DENTALTHERAPIST

Practitioner Dental Therapist Winona, MN

Practice location

Address: 720 E Highway 61, Winona, MN 55987-5300
Phone: (507) 452-9453

Registered specialties

Dental Therapist Primary

Dental Providers Taxonomy 125J00000X Licence DT117 (MN)

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Registry record

NPI: 1124663109
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Nov 2019
Record last updated: 13 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.