Organization
JODI W FUNK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODI W FUNK DDS (OWNER PRESIDNET)
(509) 747-4242
Entity
Organization
Contact information
Practice address
2829 S GRAND BLVD, STE 301, SPOKANE, WA 99203
(509) 747-4242
(509) 747-3512
Mailing address
2829 S GRAND BLVD, STE 301, SPOKANE, WA 99203
(509) 747-4242
(509) 747-3512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00001693
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5021091
DEPT OF SOCIAL & HEALTH S
WA
Enumeration date
11/22/2006
Last updated
06/18/2008
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