Stout, Bradshaw M

Stout, Bradshaw M is an sole proprietor health care provider with primary practice located at Unit 6180 , Apo AE 09604-6180. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Stout, Bradshaw M can be contacted via phone (314) 632-5463.

Contact Information

Primary practice address
Unit 6180 Apo AE 09604-6180
Phone: (314) 632-5463
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X DS035498 Pennsylvania

Profile Details

NPI number 1972594307
LBN Legal business name Stout, Bradshaw M
Credentials DMD, MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2005
Last updated Mar 16th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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