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General NPI Number Information
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NPI Number | 1891924981
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Entity Type | Individual
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Provider Name | ADAM LEONARD STOUT DMD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 7120 SMOKE RANCH RD
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City | LAS VEGAS
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State | NV
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Zip | 89128-3157
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Country | US
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Telephone | 702-798-8409
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Fax | 702-798-7203
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Provider Business Mailing Address
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Address Line | 1307 LATIGO DR
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City | HENDERSON
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State | NV
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Zip | 89002-3650
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Country | US
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Telephone | 928-460-2654
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Fax | 928-460-2654
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | S7-112
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License Number State | NV
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