| Cityline Dental Inc. | |
|
400 Reservoir Ave Suite 3d Providence RI 02907-3565 | |
| (401) 941-3353 | |
| (401) 461-6558 |
| Full Name | Cityline Dental Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 400 Reservoir Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Michael C. Furia (PRESIDENT) |
| Authorized Official Contact | 4019413353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cityline Dental Inc. 400 Reservoir Ave Suite 3d Providence RI 02907-3565 Ph: (401) 941-3353 | Cityline Dental Inc. 400 Reservoir Ave Suite 3d Providence RI 02907-3565 Ph: (401) 941-3353 |
| NPI Number | 1053537464 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053537464 | NPI | - | NPPES |
| MF26813 | Medicaid | RI | |
| CD57363 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 02534 (Rhode Island) | Primary |
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