Provider Demographics
NPI:1770065435
Name:NUNES, MAURO FORGEARINI (DDS)
Entity type:Individual
Prefix:DR
First Name:MAURO
Middle Name:FORGEARINI
Last Name:NUNES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CROASDAILE DR STE 209
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-6815
Mailing Address - Country:US
Mailing Address - Phone:919-383-7020
Mailing Address - Fax:
Practice Address - Street 1:3400 CROASDAILE DR STE 209
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6815
Practice Address - Country:US
Practice Address - Phone:919-383-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01991223G0001X
NC124751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice