Individual
DR. TESS LORRAINE FUNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1113 INDIANAPOLIS RD, GREENCASTLE, IN 46135-2408
(765) 653-4081
Mailing address
1113 INDIANAPOLIS RD, GREENCASTLE, IN 46135-2408
(765) 653-4081
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013197A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2018
Last updated
11/24/2020
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