| NPI | 1679116685 |
|---|---|
| Doing Business As | FUNKE FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | BERNARD JOSEPH BOLKA CFO 920-579-3188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |