Provider Demographics
NPI:1982872578
Name:CUEVAS, VIVIAN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:G
Last Name:CUEVAS
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 1:327 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2527
Mailing Address - Country:US
Mailing Address - Phone:651-385-9348
Mailing Address - Fax:
Practice Address - Street 1:327 BUSH ST
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2527
Practice Address - Country:US
Practice Address - Phone:651-385-9348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND106781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice