Provider Demographics
NPI:1659800720
Name:CUEVA, TRICIA MAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:TRICIA MAE
Middle Name:
Last Name:CUEVA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E BETHANY DR STE 7
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3683
Mailing Address - Country:US
Mailing Address - Phone:972-390-8500
Mailing Address - Fax:
Practice Address - Street 1:1208 E BETHANY DR STE 7
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3683
Practice Address - Country:US
Practice Address - Phone:972-390-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV70521223G0001X
TX329461223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice