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General NPI Number Information
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NPI Number | 1407102999
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Entity Type | Individual
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Provider Name | DR. SARIKA B HEGGANNAVAR
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Gender | Female
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 800 E MERRITT ISLAND CSWY
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-3514
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Country | US
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Telephone | 321-453-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 10412 PLAZA CENTRO
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City | BOCA RATON
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State | FL
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Zip | 33498-6723
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Country | US
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Telephone | 561-237-5118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN19785
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License Number State | FL
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