Organization
NICHOLAS J POURNARAS DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS J POURNARAS DMD (OWNER PRESIDENT)
(803) 794-5430
Entity
Organization
Contact information
Practice address
1801A CHARLESTON HIGHWAY, CAYCE, SC 29033
(803) 794-5430
(803) 794-0122
Mailing address
1801A CHARLESTON HIGHWAY, CAYCE, SC 29033
(803) 794-5430
(803) 794-0122
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3552
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9845
—
SC
Enumeration date
12/28/2006
Last updated
06/17/2008
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