Individual
DR. RANDY EUGENE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7812 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 393-5248
Mailing address
7812 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 393-5248
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5063
NE
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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