Provider Demographics
NPI:1295198026
Name:ALLEGRO ORTHODONTICS, PC
Entity Type:Organization
Organization Name:ALLEGRO ORTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:NAZAROV
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:720-842-4544
Mailing Address - Street 1:390 S DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1325
Mailing Address - Country:US
Mailing Address - Phone:720-842-4544
Mailing Address - Fax:720-842-5343
Practice Address - Street 1:1570 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2404
Practice Address - Country:US
Practice Address - Phone:720-842-4544
Practice Address - Fax:720-842-5343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO85301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty