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General NPI Number Information
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NPI Number | 1053537464
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Entity Type | Organization
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Legal Business Name | CITYLINE DENTAL INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 400 RESERVOIR AVE STE 1D
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City | PROVIDENCE
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State | RI
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Zip | 02907-3594
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Country | US
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Telephone | 401-941-3353
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Fax | 401-461-6558
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Provider Business Mailing Address
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Address Line | 400 RESERVOIR AVE STE 1D
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City | PROVIDENCE
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State | RI
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Zip | 02907-3594
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Country | US
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Telephone | 401-941-3353
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Fax | 401-461-6558
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL C. FURIA
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Credential | D.M.D.
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Telephone | 401-941-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 02534
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License Number State | RI
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