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General NPI Number Information
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NPI Number | 1619282753
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Entity Type | Organization
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Legal Business Name | DRESS COSMETIC SURGERY, P.A.
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 11 RACETRACK RD NE STE. E4
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1882
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Country | US
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Telephone | 850-200-5475
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Fax | 850-200-5476
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Provider Business Mailing Address
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Address Line | 11 RACETRACK RD NE STE. E4
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-1882
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Country | US
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Telephone | 850-200-5475
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Fax | 850-200-5476
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Authorized Official
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Title or Position | OWNER & PRESIDENT
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Name | DR. CHRISTOPHER MICHAEL DRESS
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Credential | M.D.
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Telephone | 850-855-8158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME87448
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License Number State | FL
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