Healthcare Provider Details
I. General information
NPI: 1891628020
Provider Name (Legal Business Name): PABLO J CUEVAS III, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
111 BEACH RD
FAIRFIELD CT
06824-6668
US
IV. Provider business mailing address
111 BEACH RD
FAIRFIELD CT
06824-6668
US
V. Phone/Fax
- Phone: 203-254-0545
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PABLO
CUEVAS
Title or Position: DENTIST
Credential: DDS
Phone: 203-254-0545