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Individual
DR. GREGORY W STOUT
Active
Individual
DR. GREGORY W STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS22182
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141448
CHAMBG - UNITED CONC
PA
01
—
1768456
MER - UNITED CONC
PA
01
—
1768458
MC - UNITED CONC
PA
Enumeration date
06/26/2006
Last updated
07/08/2007
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