Organization
CARLA D PENA DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA D PENA DDS (PRESIDENT)
(209) 830-7477
Entity
Organization
Contact information
Practice address
1401 W 11TH ST STE A, TRACY, CA 95376-3702
(209) 830-7477
(209) 830-7977
Mailing address
1401 W 11TH ST STE A, TRACY, CA 95376-3702
(209) 830-7477
(209) 830-7977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
47774
CA
Other
Enumeration date
04/27/2013
Last updated
04/27/2013
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