Provider Demographics
NPI:1467293084
Name:CUBRA, TREVOR CLANCY (DDS)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:CLANCY
Last Name:CUBRA
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 1:2422 E BLUE DIAMOND DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6691
Mailing Address - Country:US
Mailing Address - Phone:614-857-5355
Mailing Address - Fax:
Practice Address - Street 1:1402 E TUCSON MARKETPLACE BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-0006
Practice Address - Country:US
Practice Address - Phone:520-290-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program