Provider Demographics
NPI:1568550648
Name:GUTHRIE, JAMIE LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LYNN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 WALNUT DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2364
Mailing Address - Country:US
Mailing Address - Phone:580-224-9600
Mailing Address - Fax:580-224-9603
Practice Address - Street 1:1119 WALNUT DR
Practice Address - Street 2:SUITE 3
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2364
Practice Address - Country:US
Practice Address - Phone:580-224-9600
Practice Address - Fax:580-224-9603
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK55651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice