Individual
THERON ANDREW STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8310 MORRO RD, ATASCADERO, CA 93422-3927
(805) 464-2723
(805) 464-2726
Mailing address
209 MEADOWLARK RD, PASO ROBLES, CA 93446
(805) 239-3744
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
50103
CA
Other
Enumeration date
04/17/2007
Last updated
10/19/2022
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