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Organization
DR. FERNANDO DE LA PENA DENTAL CORPORATION
Active
Organization
DR. FERNANDO DE LA PENA DENTAL CORPORATION
Active
Other names
De La Pena Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERNANDO DE LA PENA D.M.D. (PRESIDENT)
(213) 389-6211
Entity
Organization
Contact information
Practice address
2701 BEVERLY BLVD, LOS ANGELES, CA 90057-1007
(213) 389-6211
Mailing address
2701 BEVERLY BLVD, LOS ANGELES, CA 90057-1007
(213) 389-6211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43934
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B43934-01
DENTI-CAL PROVIDER NO.
CA
Enumeration date
03/05/2007
Last updated
09/10/2008
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