Healthcare Provider Details

I. General information

NPI: 1215217674
Provider Name (Legal Business Name): CECILIA CUAIRAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA-CECILIA CUAIRAN-CHAVARRIA

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3302 GASTON AVE
DALLAS TX
75246-2013
US

IV. Provider business mailing address

3302 GASTON AVE
DALLAS TX
75246-2013
US

V. Phone/Fax

Practice location:
  • Phone: 214-828-8172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: