Justin Stout DMD

NPI 1699053017 - Dentist - 122300000X

NPI Details
NPI 1699053017
Gender Male
Enumeration Date 08/02/2011
Last Updated 07/27/2013
Entity Type Individual
Active Over 5 years ago
Practice Location
4360 E MAIN ST STE C
VENTURA CA, 93003-8279, US
Phone (805) 644-6110
Fax
Business Location
11691 NORTHDALE DR
MOORPARK CA, 93021-3708, US
Phone (805) 217-1611
Fax
Toxanomy
Taxonomy Code 122300000X
License State Massachusetts
License Number 1855791
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According to our database, Dr. Justin Stout DMD NPI is 1699053017, taxonomy code is 122300000X and license number is 1855791, license state is located at Massachusetts. Justin Stout DMD physically located at 4360 E Main St Ste C, Ventura CA, 93003-8279. NPI Number Justin Stout DMD has the Individual type.

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1699053017 NPI number is provided on an as is basis without warranty of any kind. 1699053017 is maintained by the National Plan & Provider Enumeration System. The contents of Justin Stout DMD are for informational purposes only.