Provider Demographics
NPI:1598974172
Name:ALEGRE, BRANDON CESAR (DMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:CESAR
Last Name:ALEGRE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 W PALMETTO PARK RD
Mailing Address - Street 2:SUITE 206B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3458
Mailing Address - Country:US
Mailing Address - Phone:561-347-0105
Mailing Address - Fax:561-447-8636
Practice Address - Street 1:7301 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 206B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3458
Practice Address - Country:US
Practice Address - Phone:561-347-0105
Practice Address - Fax:561-447-8636
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 171581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice