Individual
DR. ROBERT DALLAS FUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12 PENNS TRAIL, SUITE 154, NEWTOWN, PA 18940-3438
(215) 675-3005
(888) 662-0859
Mailing address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024103L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012633650007
—
PA
Enumeration date
09/15/2006
Last updated
03/13/2013
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