Individual
TAMARA LYNN GIERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
477 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 355-0855
(812) 355-0858
Mailing address
477 S LANDMARK AVE, BLOOMINGTON, IN 47403-5005
(812) 355-0855
(812) 355-0858
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12011121A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200897320A
—
IN
Enumeration date
07/24/2007
Last updated
09/09/2008
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