Individual
SIERRA STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1600 NW GARDEN VALLEY BLVD STE 110, ROSEBURG, OR 97471-8709
(541) 677-4851
Mailing address
775 NE NASH ST, ROSEBURG, OR 97470-3253
(541) 576-4391
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7833
OR
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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