Individual
DR. BONNIE LYNNE FUNK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
401 S WHITE MOUNTAIN RD, SHOW LOW, AZ 85901-6112
(928) 537-5005
(928) 537-5017
Mailing address
401 S WHITE MOUNTAIN RD, SHOW LOW, AZ 85901-6112
(928) 537-5005
(928) 537-5017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AZ5403
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0497391
BLUECROSS BLUESHIELD
AZ
Enumeration date
02/20/2007
Last updated
05/09/2023
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