Provider Demographics
NPI:1740318377
Name:ALEGRE DENTAL CENTER
Entity type:Organization
Organization Name:ALEGRE DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-593-1133
Mailing Address - Street 1:160 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1529
Mailing Address - Country:US
Mailing Address - Phone:781-593-1133
Mailing Address - Fax:781-593-1171
Practice Address - Street 1:160 MARKET STREET
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1529
Practice Address - Country:US
Practice Address - Phone:781-593-1133
Practice Address - Fax:781-593-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty