Provider Demographics
NPI:1881676146
Name:DENNIS PLASTIC SURGERY CENTER
Entity Type:Organization
Organization Name:DENNIS PLASTIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DENNNIS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:251-435-5114
Mailing Address - Street 1:50B MIDTOWN PARK W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4148
Mailing Address - Country:US
Mailing Address - Phone:251-435-5114
Mailing Address - Fax:251-435-5116
Practice Address - Street 1:50B MIDTOWN PARK W
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4148
Practice Address - Country:US
Practice Address - Phone:251-435-5114
Practice Address - Fax:251-435-5116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty