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NPI Code Detail

MEDICARE: DR. SHARON PUISHAN FUNG DDS

MEDICARE: DR. SHARON PUISHAN FUNG DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2901602066MI

General Provider Information

NPI Number : 1235979451
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHARON PUISHAN FUNG DDS
Provider Business Mailing Address
First Line : 4801 VETERANS DR # MC180
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-252-1670
Fax Number :
Provider Business Practice Location Address
First Line : 4801 VETERANS DR # MC180
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-2015
Country : US
Telephone Number : 320-252-1670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2024
Last Update Date : 05/08/2026

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