MEDICARE: DR. JEFFEREY R STRICKLAND D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN16077	FL

General Provider Information

NPI Number	:	1801944640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFEREY R STRICKLAND D.M.D.

Provider Business Mailing Address
First Line	:	4359 SPANISH TRL
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-4942
Country	:	US
Telephone Number	:	850-444-9998
Fax Number	:	850-444-9980

Provider Business Practice Location Address
First Line	:	4359 SPANISH TRL
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-4942
Country	:	US
Telephone Number	:	850-444-9998
Fax Number	:	850-444-9980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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