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NPI 1467012716

NPI 1467012716 : EMILY FUNK DDS : CHESTER SPRINGS, PA

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General NPI Number Information
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    NPI Number           |    1467012716
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY FUNK DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/18/2019
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    Last Update Date     |    12/18/2023
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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            |    484-359-4615
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    Fax                  |    
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Provider Business Mailing 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            |    484-359-4615
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    DS043005
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    License Number State |    PA
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