| NPI | 1366549594 |
|---|---|
| Former Legal Business Name | MARK J. FUNT, DMD PC |
| Entity Type | Organization |
| Authorized Contact | ROBERT D MOGYOROS Owner 215-379-3382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS019726L) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-10-12 |