Individual provider · Type 1 NPI
Bradshaw M. Stout, DMD, MS
Periodontics · Niceville, FL
NPI number
1972594307
Active
Practice location
719 Bayshore Dr
Niceville, FL 32578-2527
Mailing address
209 Sweetwater Run
Niceville, FL 32578-1637
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DN29633 (FL) |
| Periodontics Primary | 1223P0300X | DN29633 (FL) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
4 other providers at this address
Other periodontics providers in Niceville
About NPI 1972594307
Bradshaw M. Stout, DMD, MS's National Provider Identifier is 1972594307, issued on Nov 3, 2005. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Niceville, FL. The record was last updated on Oct 2, 2024.