| De La Pena Dental Group | |
|
2701 Beverly Blvd Los Angeles CA 90057-1007 | |
| (213) 389-6211 | |
| Not Available |
| Full Name | De La Pena Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2701 Beverly Blvd, Los Angeles, California |
| Authorized Official Name and Position | Fernando De La Pena (PRESIDENT) |
| Authorized Official Contact | 2133896211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| De La Pena Dental Group 2701 Beverly Blvd Los Angeles CA 90057-1007 Ph: (213) 389-6211 | De La Pena Dental Group 2701 Beverly Blvd Los Angeles CA 90057-1007 Ph: (213) 389-6211 |
| NPI Number | 1740319094 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 09/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740319094 | NPI | - | NPPES |
| B43934-01 | Other | CA | DENTI-CAL PROVIDER NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43934 (California) | Primary |
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