| Nicholas J Pournaras Dmd Llc | |
|
1801a Charleston Highway Cayce SC 29033 | |
| (803) 794-5430 | |
| (803) 794-0122 |
| Full Name | Nicholas J Pournaras Dmd Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1801a Charleston Highway, Cayce, South Carolina |
| Authorized Official Name and Position | Nicholas J Pournaras (OWNER PRESIDENT) |
| Authorized Official Contact | 8037945430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas J Pournaras Dmd Llc 1801a Charleston Highway Cayce SC 29033 Ph: (803) 794-5430 | Nicholas J Pournaras Dmd Llc 1801a Charleston Highway Cayce SC 29033 Ph: (803) 794-5430 |
| NPI Number | 1083770762 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083770762 | NPI | - | NPPES |
| ZA9845 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3552 (South Carolina) | Primary |
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