Delta Katherine Stout, DMD

NPI #1780178962 in Vicksburg, Mississippi

Provider Information

NPI Number: 1780178962
Entity Type: Individual
Name: Delta Katherine Stout, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Jun 20, 2018
Last Updated: Jun 20, 2018

Practice Location

Address: 1805 MISSION 66
City: Vicksburg
State: Mississippi
ZIP Code: 39180-3709
Phone: (601) 638-2361

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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