Provider Demographics
NPI:1295954469
Name:CUEVAS, PABLO JOSE (DDS)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:JOSE
Last Name:CUEVAS
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 1:40 GATEHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1610
Mailing Address - Country:US
Mailing Address - Phone:203-445-1939
Mailing Address - Fax:
Practice Address - Street 1:111 BEACH RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6668
Practice Address - Country:US
Practice Address - Phone:203-254-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT75161223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics