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General NPI Number Information
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NPI Number | 1861400855
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Entity Type | Individual
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Provider Name | ROBERT A PENNA DMD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 2710 CENTERVILLE RD STE 215
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City | WILMINGTON
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State | DE
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Zip | 19808-1664
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Country | US
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Telephone | 302-998-8783
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Fax | 302-998-8786
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Provider Business Mailing Address
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Address Line | 2710 CENTERVILLE RD STE 215
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City | WILMINGTON
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State | DE
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Zip | 19808-1664
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Country | US
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Telephone | 302-998-8783
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Fax | 302-998-8786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS029074L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | G10001080
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | GI0001080
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License Number State | DE
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