Provider Demographics
NPI:1366761389
Name:CUNHA, RENATA (DDS)
Entity type:Individual
Prefix:DR
First Name:RENATA
Middle Name:
Last Name:CUNHA
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 1:1990 N. FEDERAL HWY #B
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062
Mailing Address - Country:US
Mailing Address - Phone:954-840-6619
Mailing Address - Fax:754-220-6054
Practice Address - Street 1:1990 N FEDERAL HWY STE B
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1032
Practice Address - Country:US
Practice Address - Phone:954-840-6619
Practice Address - Fax:754-220-6054
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601567001223G0001X
FLFC DN 195281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice