Organization
DEMETRIOS G. POURLOS, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEMETRIOS GEORGE POURLOS D.D.S. (OWNER)
(704) 542-6533
Entity
Organization
Contact information
Practice address
7251 PINEVILLE MATTHEWS RD, SUITE 100, CHARLOTTE, NC 28226-6158
(704) 542-6533
(704) 540-1849
Mailing address
7251 PINEVILLE MATTHEWS RD, SUITE 100, CHARLOTTE, NC 28226-6158
(704) 542-6533
(704) 540-1849
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5324
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
97025
BLUE CROSS BLUE SHIELD
NC
Enumeration date
07/01/2006
Last updated
08/22/2020
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