| 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 Dentists |
| 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 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
