MEDICARE: DR. HEATHER ALTHEA ADU-SARKODIE DDS, PHD

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	DN16645	FL

General Provider Information

NPI Number	:	1891866687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER ALTHEA ADU-SARKODIE DDS, PHD

Provider Business Mailing Address
First Line	:	12711 MCGREGOR BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4412
Country	:	US
Telephone Number	:	239-728-3636
Fax Number	:	239-693-3637

Provider Business Practice Location Address
First Line	:	12711 MCGREGOR BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4412
Country	:	US
Telephone Number	:	239-728-3636
Fax Number	:	239-693-3637

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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