Individual
DR. MATTHEW MICHAEL STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
192 DYCKMAN ST, NEW YORK, NY 10040
(347) 801-8888
Mailing address
192 DYCKMAN ST, NEW YORK, NY 10040
(347) 801-8888
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
061531-01
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE60608034
WA
Other
Enumeration date
02/16/2016
Last updated
05/19/2022
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