Individual
DR. TARAH MARIE GERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
Mailing address
6226 14TH AVE, KENOSHA, WI 53143-4413
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7062-15
WI
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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