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Individual

DR. DEREK CHRISTOPHER FUNK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1345 E 3900 S, SUITE 108, SALT LAKE CITY, UT 84124-1474
(801) 274-3768
(801) 273-9768
Mailing address
303 N MCKINNEY ST, SUITE A, SWEENY, TX 77480
(979) 548-2184

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
31378
TX
1223G0001X
General Practice Dentistry
7702857-9921
UT

Other

Enumeration date
08/02/2010
Last updated
06/30/2017
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