Organization
TRUMBULL PREMIER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PABLO CUEVAS III DDS (SOLE MEMBER)
(203) 374-4300
Entity
Organization
Contact information
Practice address
4161 MADISON AVE, TRUMBULL, CT 06611-3533
(203) 374-4300
(203) 374-0479
Mailing address
4161 MADISON AVE, TRUMBULL, CT 06611-3533
(203) 374-4300
(203) 374-0479
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7516
CT
Other
Enumeration date
01/03/2016
Last updated
01/03/2016
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