| Name: | Cityline Dental, Incorporated |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 23 Jun 2005 (20 years ago) |
| Identification Number: | 000148804 |
| ZIP code: | 02907 |
| County: | Providence County |
| Principal Address: | 400 RESERVOIR AVENUE, PROVIDENCE, RI, 02907, USA |
| Purpose: | DENTAL OFFICE |
NAICS
621210 Offices of DentistsThis industry comprises establishments of health practitioners having the degree of D.M.D. (Doctor of Dental Medicine), D.D.S. (Doctor of Dental Surgery), or D.D.Sc. (Doctor of Dental Science) primarily engaged in the independent practice of general or specialized dentistry or dental surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. They can provide either comprehensive preventive, cosmetic, or emergency care, or specialize in a single field of dentistry. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053537464 | 2007-04-17 | 2020-08-22 | 400 RESERVOIR AVE, SUITE 3D, PROVIDENCE, RI, 029073565, US | 400 RESERVOIR AVE, SUITE 3D, PROVIDENCE, RI, 029073565, US | |||||||||||||||||||||||||||||||
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| Phone | +1 401-941-3353 |
| Fax | 4014616558 |
Authorized person
| Name | DR. MICHAEL C. FURIA |
| Role | PRESIDENT |
| Phone | 4019413353 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| License Number | 02534 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | MF26813 |
| State | RI |
| Issuer | MEDICAID |
| Number | CD57363 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| MICHAEL A. DEVARE | Agent | 100 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02860, USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL FURIA | PRESIDENT | 400 RESERVOIR AVENUE PROVIDENCE, RI 02907 USA |
| Number | Name | File Date |
|---|---|---|
| 202451351290 | Annual Report | 2024-04-17 |
| 202336752350 | Annual Report | 2023-06-12 |
| 202216724020 | Annual Report | 2022-04-25 |
| 202196319160 | Annual Report | 2021-05-07 |
| 202036949690 | Annual Report | 2020-03-30 |
| 201988373140 | Annual Report | 2019-03-08 |
| 201860653940 | Annual Report | 2018-03-19 |
| 201858793100 | Statement of Change of Registered/Resident Agent Office | 2018-02-22 |
| 201856492960 | Revocation Notice For Failure to Maintain a Registered Office | 2018-01-22 |
| 201755138770 | Registered Office Not Maintained | 2017-12-15 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8564198406 | 2021-02-13 | 0165 | PPS | 400 Reservoir Ave Ste 1D, Providence, RI, 02907-3594 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3315897110 | 2020-04-11 | 0165 | PPP | 400 Reservoir Ave Suite 1D, PROVIDENCE, RI, 02907-3549 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
