Provider Demographics
NPI:1780907378
Name:TRIMOR-VELASCO, MILAGROS GALLARDO (DDS)
Entity type:Individual
Prefix:DR
First Name:MILAGROS
Middle Name:GALLARDO
Last Name:TRIMOR-VELASCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14725 SEVENTH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4028
Mailing Address - Country:US
Mailing Address - Phone:760-951-8800
Mailing Address - Fax:
Practice Address - Street 1:14725 SEVENTH ST STE 700
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4028
Practice Address - Country:US
Practice Address - Phone:760-951-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist