| NPI | 1174552319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIOS GEORGE POURLOS Owner 704-542-6533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5324) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |