Individual
DR. HECTOR PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3255 83RD ST, GROUND FLOOR, EAST ELMHURST, NY 11370-2007
(718) 313-0613
Mailing address
1312 LITTLE NECK AVE, NORTH BELLMORE, NY 11710-1852
(917) 674-0811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
050912
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
050912
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
11343
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02420111
—
NY
01
—
9176251
DORAL USA DENTAL PROVIDER
NY
Enumeration date
07/25/2006
Last updated
07/13/2015
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