Provider Demographics
NPI:1659592426
Name:STRICKLIN, JAMMIE KENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMMIE
Middle Name:KENT
Last Name:STRICKLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SMALL STREET
Mailing Address - Street 2:P.O. BOX 866
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946
Mailing Address - Country:US
Mailing Address - Phone:618-252-1725
Mailing Address - Fax:618-252-5437
Practice Address - Street 1:300 SMALL STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:61946
Practice Address - Country:US
Practice Address - Phone:618-252-1725
Practice Address - Fax:618-252-5437
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice