| Carla D Pena Dds Inc | |
|
1401 W 11th St Ste A Tracy CA 95376-3702 | |
| (209) 830-7477 | |
| (209) 830-7977 |
| Full Name | Carla D Pena Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1401 W 11th St Ste A, Tracy, California |
| Authorized Official Name and Position | Carla D Pena (PRESIDENT) |
| Authorized Official Contact | 2098307477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carla D Pena Dds Inc 1401 W 11th St Ste A Tracy CA 95376-3702 Ph: (209) 830-7477 | Carla D Pena Dds Inc 1401 W 11th St Ste A Tracy CA 95376-3702 Ph: (209) 830-7477 |
| NPI Number | 1497199830 |
|---|---|
| Provider Enumeration Date | 04/27/2013 |
| Last Update Date | 04/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497199830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 47774 (California) | Primary |
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