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General NPI Number Information
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NPI Number | 1356912166
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Entity Type | Organization
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Legal Business Name | EMILY FUNK ORTHODONTICS LLC
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 240 WINDGATE DR STE A6
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City | CHESTER SPRINGS
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State | PA
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Zip | 19425-3643
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Country | US
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Telephone | 484-886-9494
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Fax |
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Provider Business Mailing Address
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Address Line | 104 CRICKET DR
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City | MALVERN
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State | PA
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Zip | 19355-1547
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. EMILY FUNK
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Credential | DDS
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Telephone | 484-886-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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