| Araceli Stout D.d.s. Inc. | |
|
4762 Whittier Blvd Los Angeles CA 90022-3026 | |
| (323) 604-9555 | |
| (323) 604-9555 |
| Full Name | Araceli Stout D.d.s. Inc. |
|---|---|
| Speciality | Dentist |
| Location | 4762 Whittier Blvd, Los Angeles, California |
| Authorized Official Name and Position | Araceli Stout (DENTIST) |
| Authorized Official Contact | 3236049555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Araceli Stout D.d.s. Inc. 4762 Whittier Blvd Los Angeles CA 90022-3026 Ph: (323) 604-9555 | Araceli Stout D.d.s. Inc. 4762 Whittier Blvd Los Angeles CA 90022-3026 Ph: (323) 604-9555 |
| NPI Number | 1659746881 |
|---|---|
| Provider Enumeration Date | 12/14/2015 |
| Last Update Date | 12/14/2015 |
| Medicare PECOS PAC ID | 1557691466 |
|---|---|
| Medicare Enrollment ID | O20190919000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659746881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 64440 (California) | Primary |
| Provider Name | Araceli Stout |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043699754 PECOS PAC ID: 4284964198 Enrollment ID: I20190919000394 |
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