Individual
ALEXANDRA PENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
102 SHORE DR STE 302, WORCESTER, MA 01605-3154
(508) 854-9994
Mailing address
899 CONGRESS ST APT 602, BOSTON, MA 02210-2818
(617) 347-0349
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS043482
PA
1223P0221X
Pediatric Dentistry
Primary
DN1859765
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
07/23/2021
Last updated
01/29/2024
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