Provider Demographics
NPI:1871209437
Name:JUAN F FUNES
Entity type:Organization
Organization Name:JUAN F FUNES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FUNES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-488-3200
Mailing Address - Street 1:JOSE CLEMENTE OROZCO 2468
Mailing Address - Street 2:
Mailing Address - City:TIJUANA
Mailing Address - State:BC
Mailing Address - Zip Code:22010
Mailing Address - Country:MX
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JOSE CLEMENTE OROZCO 2468
Practice Address - Street 2:
Practice Address - City:TIJUANA
Practice Address - State:BC
Practice Address - Zip Code:22010
Practice Address - Country:MX
Practice Address - Phone:619-488-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty