Individual
DENNIOR DELA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3222
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
UT
376K00000X
Nurse's Aide
00999407
CA
Other
Enumeration date
10/20/2020
Last updated
07/07/2021
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