Individual
CARMINE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
23 BOND ST STE 5, GREAT NECK, NY 11021-2025
(516) 482-4777
Mailing address
3132 38TH ST STE 1C, ASTORIA, NY 11103-3595
(718) 545-7770
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
059459
NY
1223G0001X
General Practice Dentistry
059459
NY
390200000X
Student in an Organized Health Care Education/Training Program
059459
NY
Other
Enumeration date
02/16/2016
Last updated
02/04/2026
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