# ALLEGRO DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508275421
- **Authorized official:** GRACE LEE (DENTIST)
- **Authorized official phone:** (917) 407-8034

## Contact information

- **Practice address:** 100 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2207
- **Practice address phone:** (215) 290-8230
- **Mailing address:** 100 E ALLEGHENY AVE, PHILADELPHIA, PA 19134-2207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS039072 | PA | Yes |

## Other

- **Enumeration date:** 08/05/2014
- **Last updated:** 08/05/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1027531850002 | — | PA |