Provider Demographics
NPI:1306942867
Name:RI DENTAL SURGERY & IMPLANTS, LTD.
Entity type:Organization
Organization Name:RI DENTAL SURGERY & IMPLANTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEUNES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-353-1515
Mailing Address - Street 1:468 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4238
Mailing Address - Country:US
Mailing Address - Phone:401-353-1515
Mailing Address - Fax:401-353-0005
Practice Address - Street 1:468 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4238
Practice Address - Country:US
Practice Address - Phone:401-353-1515
Practice Address - Fax:401-353-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN025231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI859082045Medicare ID - Type UnspecifiedMEDICARE GROUP ID