Provider Demographics
NPI:1841354859
Name:KRESS, PHILIP ISAAC (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ISAAC
Last Name:KRESS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13275 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7307
Mailing Address - Country:US
Mailing Address - Phone:562-924-8663
Mailing Address - Fax:562-924-8890
Practice Address - Street 1:13275 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-7307
Practice Address - Country:US
Practice Address - Phone:562-924-8663
Practice Address - Fax:562-924-8890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist