Organization
PLASTIC & COSMETIC SURGERY INSTITUTE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID C WATTS MD (CEO)
(856) 691-0200
Entity
Organization
Contact information
Practice address
1051 W SHERMAN AVE, BLDG 2, SUITE A, VINELAND, NJ 08360-6931
(856) 691-0200
(856) 691-5984
Mailing address
1051 W SHERMAN AVE, BLDG 2, SUITE A, VINELAND, NJ 08360-6931
(856) 691-0200
(856) 691-5984
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06143100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6527400
—
NJ
Enumeration date
09/14/2010
Last updated
12/14/2010
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