Provider Demographics
NPI:1417014598
Name:ALLEGRETTI, SCOTT A (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:ALLEGRETTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:A
Other - Last Name:ALLEGRETTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:135 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:PROVINCETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02657-1430
Mailing Address - Country:US
Mailing Address - Phone:508-487-2800
Mailing Address - Fax:
Practice Address - Street 1:135 BRADFORD ST
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1430
Practice Address - Country:US
Practice Address - Phone:508-487-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA815388OtherUCCI