Individual
TAMARA LYNN GIERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
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
Update your record
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