Provider Demographics
NPI:1851466551
Name:COUSINS, CONSTANCE MAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:MAY
Last Name:COUSINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 UPDIKE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5728
Mailing Address - Country:US
Mailing Address - Phone:401-295-1992
Mailing Address - Fax:
Practice Address - Street 1:29 UPDIKE AVE
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5728
Practice Address - Country:US
Practice Address - Phone:401-295-1992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2249208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice