Individual
DR. JONATHAN FUNTANILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-7410
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011205
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D011205
DENTAL LICENSE
AZ
Enumeration date
10/13/2021
Last updated
06/23/2025
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