| Pournaras Cosmetics | |
|
1211 44th Ave. N. 100 Myrtle Beach SC 29577 | |
| (843) 449-3161 | |
| (843) 449-9785 |
| Full Name | Pournaras Cosmetics |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1211 44th Ave. N., Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Vasilios J. Pournaras (OWNER) |
| Authorized Official Contact | 8434493161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pournaras Cosmetics 1211 44th Ave. N. 100 Myrtle Beach SC 29577 Ph: (843) 449-3161 | Pournaras Cosmetics 1211 44th Ave. N. 100 Myrtle Beach SC 29577 Ph: (843) 449-3161 |
| NPI Number | 1265642771 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265642771 | NPI | - | NPPES |
| ZX3697 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | SC3697 (South Carolina) | Primary |
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