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General NPI Number Information
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NPI Number | 1952362931
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Entity Type | Individual
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Provider Name | MICHAEL ADU-TUTU DDS
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Gender | Male
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 714 AVENUE C
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City | FORT PIERCE
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State | FL
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Zip | 34950-4189
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Country | US
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Telephone | 772-462-3874
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Fax | 772-462-3880
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Provider Business Mailing Address
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Address Line | 5150 NW MILNER DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34983-3392
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Country | US
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Telephone | 772-462-3874
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Fax | 772-462-3874
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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 | D2934
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN10216
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 56698
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS0000004304
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License Number State | TN
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