| Michael E. Stout, Dds Pc | |
|
30 Stoneridge Dr Suite 102 Waynesboro VA 22980-6522 | |
| (540) 949-8053 | |
| (540) 943-2505 |
| Full Name | Michael E. Stout, Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 30 Stoneridge Dr, Waynesboro, Virginia |
| Authorized Official Name and Position | Michael Stout (OWNER) |
| Authorized Official Contact | 5409498053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael E. Stout, Dds Pc 30 Stoneridge Dr Suite 102 Waynesboro VA 22980-6522 Ph: (540) 949-8053 | Michael E. Stout, Dds Pc 30 Stoneridge Dr Suite 102 Waynesboro VA 22980-6522 Ph: (540) 949-8053 |
| NPI Number | 1891978029 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 12/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891978029 | NPI | - | NPPES |
| 7801114 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | VA0401007125 (Virginia) | Primary |
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