Organization
MICHAEL E. STOUT, DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL STOUT DDS (OWNER)
(540) 949-8053
Entity
Organization
Contact information
Practice address
30 STONERIDGE DR, SUITE 102, WAYNESBORO, VA 22980-6522
(540) 949-8053
(540) 943-2505
Mailing address
30 STONERIDGE DR, SUITE 102, WAYNESBORO, VA 22980-6522
(540) 949-8053
(540) 943-2505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
VA0401007125
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801114
—
VA
Enumeration date
12/11/2007
Last updated
12/11/2007
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