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General NPI Number Information
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NPI Number | 1972087930
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Entity Type | Organization
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Legal Business Name | NEW ERA DENTAL GROUP, PA
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 2011 W 62ND ST
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City | HIALEAH
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State | FL
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Zip | 33016-2657
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Country | US
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Telephone | 867-558-8637
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Fax | 786-558-8638
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Provider Business Mailing Address
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Address Line | 7755 SW 87TH AVE STE 120
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City | MIAMI
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State | FL
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Zip | 33173-2534
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Country | US
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Telephone | 305-271-0160
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Fax | 305-271-0160
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANNY PENA
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Credential | DMD
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Telephone | 305-271-0160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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