Provider Demographics
NPI:1598708190
Name:STOUT, MARWOOD M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARWOOD
Middle Name:M
Last Name:STOUT
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:1701 SOLAR DR
Mailing Address - Street 2:SUITE 291
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0134
Mailing Address - Country:US
Mailing Address - Phone:805-981-8144
Mailing Address - Fax:805-981-8146
Practice Address - Street 1:1701 SOLAR DR
Practice Address - Street 2:SUITE 291
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0134
Practice Address - Country:US
Practice Address - Phone:805-981-8144
Practice Address - Fax:805-981-8146
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA362871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery