Provider Demographics
NPI:1124308812
Name:SKORDAS, FOTIOS A (MS, DDS)
Entity type:Individual
Prefix:DR
First Name:FOTIOS
Middle Name:A
Last Name:SKORDAS
Suffix:
Gender:M
Credentials:MS, DDS
Other - Prefix:
Other - First Name:F.
Other - Middle Name:A
Other - Last Name:SKORDAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, DDS, PL
Mailing Address - Street 1:7129 CURTISS AVE
Mailing Address - Street 2:#2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8080
Mailing Address - Country:US
Mailing Address - Phone:941-922-8811
Mailing Address - Fax:
Practice Address - Street 1:7129 CURTISS AVE
Practice Address - Street 2:#2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8080
Practice Address - Country:US
Practice Address - Phone:941-922-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN136451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice