Individual
STACI STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, BSDH
Contact information
Practice address
3113 W SWISS PASS CIR, SOUTH JORDAN, UT 84095
(801) 678-1221
Mailing address
3113 W SWISS PASS CIR, SOUTH JORDAN, UT 84095-8489
(801) 678-1221
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5328323-9920
UT
Other
Enumeration date
08/07/2017
Last updated
07/21/2022
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