Provider Demographics
NPI:1093099327
Name:TRIGUEROS, CHRISTIANE MARIE (DMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:MARIE
Last Name:TRIGUEROS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CHRISTIANE
Other - Middle Name:MARIE
Other - Last Name:COLOMBERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:338 S DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:VANDENBERG AFB
Mailing Address - State:CA
Mailing Address - Zip Code:93437-6307
Mailing Address - Country:US
Mailing Address - Phone:805-605-4085
Mailing Address - Fax:
Practice Address - Street 1:338 S DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:VANDENBERG AFB
Practice Address - State:CA
Practice Address - Zip Code:93437-6307
Practice Address - Country:US
Practice Address - Phone:805-605-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8025980-8903122300000X
UT8025980-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist