Provider Demographics
NPI:1508999350
Name:STRICKLAND, SCOTT R (DDS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:R
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-1306
Mailing Address - Country:US
Mailing Address - Phone:616-866-1017
Mailing Address - Fax:616-866-8078
Practice Address - Street 1:380 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-1306
Practice Address - Country:US
Practice Address - Phone:616-866-1017
Practice Address - Fax:616-866-8078
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist