Organization
FLORIDA DENTAL ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS PENA (OWNER)
(305) 766-3930
Entity
Organization
Contact information
Practice address
4355 W 16 AVE SUITE, #205A, HIALEAH, FL 33012
(305) 766-3930
Mailing address
4355 W 16TH AVE STE 205A, HIALEAH, FL 33012-7668
(305) 824-9199
(305) 824-8885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/30/2017
Last updated
07/21/2022
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