Provider Demographics
NPI:1891866687
Name:ADU-SARKODIE, HEATHER ALTHEA (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ALTHEA
Last Name:ADU-SARKODIE
Suffix:
Gender:F
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12711 MCGREGOR BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4412
Mailing Address - Country:US
Mailing Address - Phone:239-728-3636
Mailing Address - Fax:239-693-3637
Practice Address - Street 1:12711 MCGREGOR BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4412
Practice Address - Country:US
Practice Address - Phone:239-728-3636
Practice Address - Fax:239-693-3637
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN166451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics