Provider Demographics
NPI:1356590962
Name:PAPPOUS, CONSTANTINOS GEORGE (DDS)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINOS
Middle Name:GEORGE
Last Name:PAPPOUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:45 N STATION PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5011
Mailing Address - Country:US
Mailing Address - Phone:516-482-6520
Mailing Address - Fax:516-482-6523
Practice Address - Street 1:45 N STATION PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5011
Practice Address - Country:US
Practice Address - Phone:516-482-6520
Practice Address - Fax:516-482-6523
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0427591223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics