Provider Demographics
NPI:1467012716
Name:FUNK, EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:FUNK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WINDGATE DR STE A6
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-3643
Mailing Address - Country:US
Mailing Address - Phone:484-359-4615
Mailing Address - Fax:
Practice Address - Street 1:240 WINDGATE DR STE A6
Practice Address - Street 2:
Practice Address - City:CHESTER SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:19425-3643
Practice Address - Country:US
Practice Address - Phone:484-359-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0430051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics