| NPI | 1306109376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH STOUT Dr. 360-424-3811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE60292936) |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2012-06-24 |