MEDICARE: DR. MICHAEL SARDZINSKI D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	DN 13440	FL

General Provider Information

NPI Number	:	1598980849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SARDZINSKI D.M.D.

Provider Business Mailing Address
First Line	:	1172 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4501
Country	:	US
Telephone Number	:	941-492-3570
Fax Number	:	941-492-3572

Provider Business Practice Location Address
First Line	:	1172 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4501
Country	:	US
Telephone Number	:	941-492-3570
Fax Number	:	941-492-3572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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