Provider Demographics
NPI:1407015191
Name:THOMAS R SCHIERBROCK DDS ANDREA L CORDENZANA DDS PLC
Entity Type:Organization
Organization Name:THOMAS R SCHIERBROCK DDS ANDREA L CORDENZANA DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SCHIERBROCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-322-5318
Mailing Address - Street 1:427 E KANESVILLE BLVD
Mailing Address - Street 2:#200
Mailing Address - City:CO BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-4403
Mailing Address - Country:US
Mailing Address - Phone:712-322-5318
Mailing Address - Fax:712-329-6128
Practice Address - Street 1:427 E KANESVILLE BLVD
Practice Address - Street 2:#200
Practice Address - City:CO BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4403
Practice Address - Country:US
Practice Address - Phone:712-322-5318
Practice Address - Fax:712-329-6128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty