| William Stout Dental Pllc | |
|
286 E Moody Rd Ste E&f Rexburg ID 83440-5566 | |
| (509) 551-9963 | |
| Not Available |
| Full Name | William Stout Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 286 E Moody Rd Ste E&f, Rexburg, Idaho |
| Authorized Official Name and Position | William Craig Stout (DOCTOR/OWNER) |
| Authorized Official Contact | 5095519963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William Stout Dental Pllc 286 E Moody Rd Ste E&f Rexburg ID 83440-5566 Ph: (509) 551-9963 | William Stout Dental Pllc 286 E Moody Rd Ste E&f Rexburg ID 83440-5566 Ph: (509) 551-9963 |
| NPI Number | 1912716507 |
|---|---|
| Provider Enumeration Date | 01/07/2025 |
| Last Update Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912716507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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