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General NPI Number Information
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NPI Number | 1356590962
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Entity Type | Individual
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Provider Name | CONSTANTINOS GEORGE PAPPOUS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 45 N STATION PLZ SUITE 100
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City | GREAT NECK
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State | NY
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Zip | 11021-5011
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Country | US
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Telephone | 516-482-6520
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Fax | 516-482-6523
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Provider Business Mailing Address
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Address Line | 45 N STATION PLZ SUITE 100
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City | GREAT NECK
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State | NY
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Zip | 11021-5011
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Country | US
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Telephone | 516-482-6520
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Fax | 516-482-6523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 042759
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License Number State | NY
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