Provider Demographics
NPI:1972087930
Name:NEW ERA DENTAL GROUP, PA
Entity type:Organization
Organization Name:NEW ERA DENTAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-271-0160
Mailing Address - Street 1:7755 SW 87TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2534
Mailing Address - Country:US
Mailing Address - Phone:305-271-0160
Mailing Address - Fax:305-271-0160
Practice Address - Street 1:2011 W 62ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2657
Practice Address - Country:US
Practice Address - Phone:867-558-8637
Practice Address - Fax:786-558-8638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental