Provider Demographics
NPI:1740342476
Name:MANUEL M. CUNANAN D.M.D. INC.
Entity type:Organization
Organization Name:MANUEL M. CUNANAN D.M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUNANAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-737-7715
Mailing Address - Street 1:3411 W SHORE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7561
Mailing Address - Country:US
Mailing Address - Phone:401-737-7716
Mailing Address - Fax:401-734-9580
Practice Address - Street 1:3411 W SHORE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7561
Practice Address - Country:US
Practice Address - Phone:401-737-7716
Practice Address - Fax:401-734-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1867261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental