Rallis, David J

Rallis, David J is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Rallis, David J can be contacted via phone (507) 284-2511.

Contact Information

Primary practice address
200 1St St Sw Rochester MN 55905-0001
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 11973 Minnesota
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 52037 Minnesota

Profile Details

NPI number 1275500076
LBN Legal business name Rallis, David J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Apr 23rd, 2014 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1275500076 NPPES
Minnesota MEDICAID 343643800
Minnesota MEDICAID ENROLLED

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