Provider Demographics
NPI:1730285289
Name:GEUNES, PAUL M (DMD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:GEUNES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN025231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDEN02523OtherDENTAL LICENSE
RIDEN02523OtherDENTAL LICENSE