Individual
DR. ALBA M PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 N ALEXANDER ST, PLANT CITY, FL 33563-4306
(813) 752-5520
(940) 766-6504
Mailing address
420 N ALEXANDER ST, PLANT CITY, FL 33563-4306
(813) 752-5520
(940) 766-6504
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
31709
TX
122300000X
Dentist
DN23824
FL
1223G0001X
General Practice Dentistry
Primary
DN23824
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31709
STATE LICENSE
TX
Enumeration date
03/07/2016
Last updated
11/12/2020
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