SHANNON STOUT

FORT DRUM, NY
NPI1689023376
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: NY  027425)
Enumeration Date2016-06-03
Last Update Date2016-06-03
Business Address
Mrs. SHANNON STOUT Dental Hygienist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602-5005
Phone number: 315-772-6234
Mailing Address
Mrs. SHANNON STOUT Dental Hygienist
10590 ENDURING FREEDOM DR
FORT DRUM, NY 13602-5005
Phone number: 315-772-6234
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