# MICHAEL STOUT DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215656285
- **Authorized official:** THOMAS CHILDRESS (OFFICE MANAGER)
- **Authorized official phone:** (540) 949-8053

## Contact information

- **Practice address:** 30 STONERIDGE DR STE 102, WAYNESBORO, VA 22980-6522
- **Practice address phone:** (540) 949-8053
- **Mailing address:** 30 STONERIDGE DR STE 102, WAYNESBORO, VA 22980-6522
- **Mailing address phone:** (540) 949-8053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2022
- **Last updated:** 08/24/2022